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目的比较第三代静注溶栓药物瑞替普酶(rPA)和阿替普酶(rt-PA)对急性心肌梗死(AMI)患者急诊静脉溶栓治疗的临床疗效。方法采用前瞻开放性临床研究方法,观察2007年3月至2009年12月期间在本院急诊室内接受rPA或rt-PA静脉溶栓治疗的AMI患者,共55例,其中rPA组24例,rt-PA组31例,观察血管再通率、病死率、平均住院天数、心力衰竭及休克等并发症和出血不良反应。结果 rPA和rt-PA组的再通率分别为87.50%和83.83%,(P>0.05)。溶栓后30d内心力衰竭、休克及再梗死发生率两组相当,(P>0.05);病死率分别为8.33%(2例)和6.45%(2例),P>0.05;轻度出血发生率分别66.66%和48.38%,P>0.05;脑出血发生率为8.33%和9.68%,P>0.05;住院天数分别为(10.74±6.49)d和(13.09±13.36)d,P>0.05。结论瑞替普酶适合急诊室内急性心肌梗死患者的静脉溶栓治疗。
Objective To compare the clinical efficacy of the third generation of intravenous thrombolysis with reteplase (rPA) and alteplase (rt-PA) in emergency thrombolysis in patients with acute myocardial infarction (AMI). Methods A prospective open clinical study was conducted to observe the AMI patients receiving rPA or rt-PA intravenous thrombolysis in our emergency department from March 2007 to December 2009, a total of 55 patients, including 24 rPA patients, rt -PA group of 31 cases, observed the rate of recanalization, mortality, the average length of stay, heart failure and shock complications and bleeding reactions. Results The recanalization rates of rPA and rt-PA were 87.50% and 83.83%, respectively (P> 0.05). The incidence of heart failure, shock and reinfarction within 30 days after thrombolysis were similar in both groups (P> 0.05). The mortality rates were 8.33% (2 cases) and 6.45% (2 cases) respectively, P> 0.05. Mild bleeding occurred The incidence of cerebral hemorrhage was 8.33% and 9.68% respectively, P> 0.05. The days of hospitalization were (10.74 ± 6.49) days and (13.09 ± 13.36) days, respectively, P> 0.05. Conclusion Reteplase is suitable for intravenous thrombolytic therapy in patients with acute myocardial infarction in emergency room.