中外医疗
中外醫療
중외의료
CHINA FOREIGN MEDICAL TREATMENT
2015年
17期
124-126,129
,共4页
急性ST段抬高型心肌梗死%静脉溶栓治疗%重组人尿激酶原
急性ST段抬高型心肌梗死%靜脈溶栓治療%重組人尿激酶原
급성ST단태고형심기경사%정맥용전치료%중조인뇨격매원
Acute ST-segment elevation myocardial infarction%Intravenous thrombolytic therapy%Recombinant human urokinase
目的：探讨重组人尿激酶原治疗急性ST段抬高型心肌梗死的疗效及安全性。方法选择急性ST段抬高型心肌梗死患者52例，根据随机数字表法将患者分为尿激酶原组和同瑞替普酶组，每组各26例。同瑞替普酶组给予同瑞替普酶治疗，重组尿激酶原组采用重组尿激酶原治疗。比较两组给药后不同时间点的纤溶酶、纤溶酶原、纤维蛋白原水平变化、冠状动脉再开通情况及心脏事件、出血程度情况。结果两组纤溶酶在给药0 h、24 h、48 h差异无统计学意义(P>0.05)，但给药2 h时，重组尿激酶原组纤溶酶明显高于同瑞替普酶组(P<0.05)；两组纤溶酶原、纤维蛋白原在给药0 h、48 h差异无统计学意义(P>0.05)，但给药2 h、24 h时，重组尿激酶原组纤溶酶原、纤维蛋白原明显高于同瑞替普酶组(P<0.05)。重组尿激酶原组的心脏事件发生率明显低于同瑞替普酶组，出血程度明显轻于同瑞替普酶组(P<0.05)。重组尿激酶原组的再通率和完全再通率明显高于同瑞替普酶组(P<0.05)。结论重组尿激酶原对急性ST段抬高型心肌梗死患者的凝血和纤溶系统影响较小，确保了溶栓效果，提高了再通和完全再通率，减少了心脏事件的发生风险及减轻再出血程度，故具有较好的临床适用性。
目的：探討重組人尿激酶原治療急性ST段抬高型心肌梗死的療效及安全性。方法選擇急性ST段抬高型心肌梗死患者52例，根據隨機數字錶法將患者分為尿激酶原組和同瑞替普酶組，每組各26例。同瑞替普酶組給予同瑞替普酶治療，重組尿激酶原組採用重組尿激酶原治療。比較兩組給藥後不同時間點的纖溶酶、纖溶酶原、纖維蛋白原水平變化、冠狀動脈再開通情況及心髒事件、齣血程度情況。結果兩組纖溶酶在給藥0 h、24 h、48 h差異無統計學意義(P>0.05)，但給藥2 h時，重組尿激酶原組纖溶酶明顯高于同瑞替普酶組(P<0.05)；兩組纖溶酶原、纖維蛋白原在給藥0 h、48 h差異無統計學意義(P>0.05)，但給藥2 h、24 h時，重組尿激酶原組纖溶酶原、纖維蛋白原明顯高于同瑞替普酶組(P<0.05)。重組尿激酶原組的心髒事件髮生率明顯低于同瑞替普酶組，齣血程度明顯輕于同瑞替普酶組(P<0.05)。重組尿激酶原組的再通率和完全再通率明顯高于同瑞替普酶組(P<0.05)。結論重組尿激酶原對急性ST段抬高型心肌梗死患者的凝血和纖溶繫統影響較小，確保瞭溶栓效果，提高瞭再通和完全再通率，減少瞭心髒事件的髮生風險及減輕再齣血程度，故具有較好的臨床適用性。
목적：탐토중조인뇨격매원치료급성ST단태고형심기경사적료효급안전성。방법선택급성ST단태고형심기경사환자52례，근거수궤수자표법장환자분위뇨격매원조화동서체보매조，매조각26례。동서체보매조급여동서체보매치료，중조뇨격매원조채용중조뇨격매원치료。비교량조급약후불동시간점적섬용매、섬용매원、섬유단백원수평변화、관상동맥재개통정황급심장사건、출혈정도정황。결과량조섬용매재급약0 h、24 h、48 h차이무통계학의의(P>0.05)，단급약2 h시，중조뇨격매원조섬용매명현고우동서체보매조(P<0.05)；량조섬용매원、섬유단백원재급약0 h、48 h차이무통계학의의(P>0.05)，단급약2 h、24 h시，중조뇨격매원조섬용매원、섬유단백원명현고우동서체보매조(P<0.05)。중조뇨격매원조적심장사건발생솔명현저우동서체보매조，출혈정도명현경우동서체보매조(P<0.05)。중조뇨격매원조적재통솔화완전재통솔명현고우동서체보매조(P<0.05)。결론중조뇨격매원대급성ST단태고형심기경사환자적응혈화섬용계통영향교소，학보료용전효과，제고료재통화완전재통솔，감소료심장사건적발생풍험급감경재출혈정도，고구유교호적림상괄용성。
Objective To investigate the efficacy and safety of recombinant human urokinase in the treatment of acute ST-segment elevation myocardial infarction. Methods 52 patients with acute ST-segment elevation myocardial infarction were selected and randomly divided into prourokinase group and reteplase group with 26 patients in each group. Patients in the reteplase group were given reteplase treatment, while recombinant prourokinase group received recombinant urokinase therapy. Of the two groups, plas-min, plasminogen, fibrinogen levels, coronary artery patency and cardiac events, the degree of bleeding situation at different time points after administration were compared. Results The administration of plasmin in 0 h, 24 h, 48 h had no significant difference (P>0.05), but when administered 2 h, plasmin of the recombinant prourokinase was significantly higher than that of the reteplase groups (P<0.05);Plasminogen, and fibrinogen 0 h and 48 h after administration of the two groups showed no significant difference between the two groups (P>0.05), Plasminogen and fibrinogen 2 h and 24 h after administration of the recombinant prourokinase group was significantly higher than that of the reteplase group (P<0.05). Cardiac event rate and bleeding of the recombinant uroki-nase was significantly lower than that of the reteplase group (P<0.05). Recanalization rate and complete recanalization rate of the recombinant urokinase was significantly lower than that of the reteplase group (P<0.05). Conclusion For patients with acute ST-segment elevation myocardial infarction, recombinant prourokinase, with lower effect on coagulation and fibrinolysis system, can ensure the thrombolytic effects, improve rate of recanalization and complete recanalization, and reduce the risk of cardiac events and extent of rebleeding, so it has a better clinical applicability.
