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目的:观察半量瑞替普酶(r-PA)溶栓治疗急性下壁心肌梗死(AIMI)的疗效。方法:选择AIMI 76例,随机分为r-PA组(观察组)40例和尿激酶组(对照组)36例。对照组给予尿激酶(UK)150万U,溶于100ml生理盐水中静脉滴注;观察组给予半量瑞替普酶10MU静脉注射,仅给予1剂。两组均常规给予阿司匹林、氯吡格雷、低分子肝素等常规抗凝血、抗血小板集聚及其他对症治疗。比较两组血管再通率,严重心律失常发作、梗死后心绞痛、心源性休克发生情况,院内病死率及出血等并发症发生情况。结果:观察组临床血管再通率82.5%,非常显著高于对照组的47.2%(P<0.01);两组急性期梗死后心绞痛、严重心律失常、心源性休克及院内病死发生率差异不显著(P>0.05)。结论:半量瑞替普酶用于急性下壁心肌梗死溶栓疗效优于尿激酶溶栓。
Objective: To observe the curative effect of semi-quantitative reteplase (r-PA) thrombolytic therapy on acute inferior wall myocardial infarction (AIMI). Methods: 76 AIMI patients were randomly divided into r-PA group (observation group) and urokinase group (control group), 40 cases. The control group was given urokinase (UK) 1.5 million U dissolved in 100 ml of normal saline intravenously; the observation group given semi-dose of reteplase 10MU intravenously, only given one. Both groups were routinely given aspirin, clopidogrel, low molecular weight heparin and other conventional anti-coagulation, anti-platelet aggregation and other symptomatic treatment. The complications such as recanalization rate, serious arrhythmia, post-infarction angina, cardiogenic shock, hospital mortality and hemorrhage were compared. Results: The rate of clinical recanalization in observation group was 82.5%, which was significantly higher than that in control group (47.2%, P <0.01). There was no difference in the incidence of angina pectoris, severe arrhythmia, cardiogenic shock and nosocomial disease in acute phase Significant (P> 0.05). Conclusion: The effect of half amount of reteplase on thrombolysis in acute inferior myocardial infarction is better than that of urokinase.