CAJ | 학술논문

目的：探讨阿替普酶治疗急性心肌梗死的临床疗效并对其不良反应进行分析。方法选取我院于2010年3月至2013年3月收治的急性心肌梗死患者共96例，将其随机分为两组，分别为实验组和对照组，每组各48人。所有患者均在就诊30min内开始静脉溶栓，实验组给予阿替普酶治疗，将阿替普酶50mg溶于50ml专用溶剂中，先静脉推注8mg，剩余42mg在90min内滴注完毕。溶栓前后均给予一定量的低分子肝素钙进行皮下注射，每天2次。对照组给予尿激酶治疗，先将150万U的尿激酶溶于100m l生理盐水中，然后于30min内滴完，随后进行APTT监测，并进行低分子肝素钙皮下注射，每天2次。两组在无严重不良反应的前提下均进行8天。结果与对照组相比，实验组患者中胸痛症状缓解和冠状动脉再通的人数稍高，但差异无统计学意义（P>0.05）；在不良反应情况中，实验组的心率失常、心力衰竭、梗死后心绞痛人数显著低于对照组（P<0.05）。结论阿替普酶的临床疗效与尿激酶相当，但不良反应低于尿激酶。
목적：탐토아체보매치료급성심기경사적림상료효병대기불량반응진행분석。방법선취아원우2010년3월지2013년3월수치적급성심기경사환자공96례，장기수궤분위량조，분별위실험조화대조조，매조각48인。소유환자균재취진30min내개시정맥용전，실험조급여아체보매치료，장아체보매50mg용우50ml전용용제중，선정맥추주8mg，잉여42mg재90min내적주완필。용전전후균급여일정량적저분자간소개진행피하주사，매천2차。대조조급여뇨격매치료，선장150만U적뇨격매용우100m l생리염수중，연후우30min내적완，수후진행APTT감측，병진행저분자간소개피하주사，매천2차。량조재무엄중불량반응적전제하균진행8천。결과여대조조상비，실험조환자중흉통증상완해화관상동맥재통적인수초고，단차이무통계학의의（P>0.05）；재불량반응정황중，실험조적심솔실상、심력쇠갈、경사후심교통인수현저저우대조조（P<0.05）。결론아체보매적림상료효여뇨격매상당，단불량반응저우뇨격매。
objective To study efficacy analysis and adverse reactions of alteplase treating acute myocardial infarction. Method Col ecting 96 cases of patients with acute myocardial infarction of our hospital from March 2010 to March 2013. We divide them into two groups randomly, and name them as the experimental group and control group,and each group has 48 people. Al patients were started on intravenous thrombolytic treatment within 30min. Experimental group received alteplase treatment. The alteplase 50 mg was dissolved in 50ml of special solvents, then intravenous injection 8mg. The remaining 42mg infusion is completed within 90min. The patients were given a certain amount of low molecular weight heparin administered subcutaneously twice daily before and after thrombolysis. The control group received urokinase treatment. 150 000 U of urokinase was dissolved in 100ml of saline and was dropped in 30min,then give patients APTT monitor. two groups were performed 8 days under the premise of the no serious adverse reactions. Result Compared with the control group, the experimental group have slightly higher number of patients with symptoms of chest pain and coronary recanalization ,but the difference was not statistical y significant(P>0.05). The number of heart disorders, heart failure, post-infarction angina in the experimental group was significantly lower than the control group (P <0.05). Conclusion The clinical efficacy of alteplase is considerable to urokinase, but adverse reactions are less than urokinase.