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目的 :探讨小剂量 ( 50mg)重组组织型纤溶酶原激活剂 (rt PA)静脉溶栓治疗急性心肌梗死(AMI)的疗效及安全性。方法 :90min内静脉注射rt PA50mg治疗AMI 116例 ,依据临床指标判断再通。应用超声心动图比较再通组与未通组的心功能。结果 :冠脉再通率、出血发生率及住院期间再梗死率分别为78 4 % ( 91/116)、14 7% ( 17/116)和 5 2 % ( 6/116) ,再通组心功能明显好于未通组 (P <0 0 1) ,5w病死率再通组 1 1%显著低于未通组 8 0 % (P <0 .0 0 1)。结论 :小剂量rt PA静脉溶栓可获较高冠脉再通率 ,明显改善心功能 ,降低病死率、出血并发症及医疗费用。
Objective: To investigate the efficacy and safety of intravenous thrombolytic therapy with recombinant human recombinant plasminogen activator (rt PA) in patients with acute myocardial infarction (AMI). Methods: One hundred and sixty-six AMI patients were treated with intravenous injection of rt PA50mg within 90 minutes, then recanalized according to the clinical indexes. Echocardiography was used to compare the cardiac function between the recanalization group and the failed group. Results: The rate of coronary recanalization, the rate of bleeding and the rate of reinfarction during hospitalization were 78 4% (91/116), 14 7% (17/116) and 52% (6/116), respectively Function was significantly better than the non-pass group (P <0 0 1), 5w fatality recanalization group 1 1% was significantly lower than the non-pass group 80% (P <0. Conclusion: The low dose rt PA intravenous thrombolysis can lead to higher coronary recanalization rate, significantly improve cardiac function, reduce mortality, bleeding complications and medical costs.