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目的观察瑞替普酶(r-PA)急诊静脉溶栓治疗急性心肌梗死(AMI)不同时间窗溶栓治疗的血管再通率及安全性。方法符合入选标准的57例无溶栓禁忌证患者在常规治疗的基础上给予r-PA18mg+0.9%氯化钠50ml快速静脉溶栓治疗,30min后再给予r-PA18mg治疗。计算发病0.5～2h、>2～4h、>4～6h及>6～12h内溶栓再通率,并将6h内溶栓病例与将>6～12h溶栓病例进行再通率比较。结果 6h内溶栓再通率为86.67%,>6～12h溶栓再通率为41.67%,2者比较差异有统计学意义(P<0.05)。结论临床上应用r-PA急诊溶栓治疗AMI疗效好,再通率高,AMI溶栓时间越早再通率越高,且安全,副作用少。
Objective To observe the safety and recanalization rate of thrombolytic therapy with reteplase (r-PA) in emergency thrombolytic therapy for acute myocardial infarction (AMI) at different time points. Methods Fifty-seven patients without thrombolysis contraindications were given intravenous thrombolysis of r-PA18mg + 0.9% sodium chloride 50ml on the basis of routine treatment, and r-PA18mg was given after 30 minutes. The recanalization rate of thrombolysis in 0.5-2h,> 2-4h,> 4-6h and> 6-12h was calculated. The rate of recanalization for thrombolysis within 6h was compared with that of thrombolysis for> 6-12h. Results The rate of thrombolysis recanalization within 6 hours was 86.67%, the rate of thrombolytic recanalization more than 6 to 12 hours was 41.67%. There was significant difference between the two groups (P <0.05). Conclusion The clinical application of r-PA emergency thrombolytic therapy for AMI has a good effect and a high recanalization rate. The earlier the thrombolysis time of AMI, the higher the recanalization rate, and the lower safety and fewer side effects.