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1目的 观察应用重组组织型纤溶酶原激活剂 (rt- PA )溶栓治疗急性心肌梗死 (AMI)的效果。 2方法 按溶栓药物不同将 94例 AMI病人分为 2组。rt- PA组 (5 5例 )先给负荷量 rt- PA 10～ 15 mg,余量 35～ 40 m g用微量泵于 30 min内泵入 ,继以 5 0 mg于 6 0 min内泵入 ,特殊情况可适当加量。尿酸氧化酶 (U K)组 (39例 )将 UK 15 0万单位于 30 m in内泵入 ,肝素不作常规应用。 3结果 rt- PA组血管再通率为 80 .0 % ,UK组为 5 6 .4% ,两组间比较差异有显著性 (χ2 =6 .0 7,P<0 .0 5 )。 rt- PA组再灌注性心律失常发生率为 6 5 .5 % ,UK组为 43.6 % ,两组间比较亦有显著差异 (χ2 =4.44 ,P<0 .0 5 )。 rt- PA组和 UK组轻度出血发生率分别为 12 .7%和 17.9% ,住院 30 d的病死率分别为 1.8%和 7.7% ,两组间比较差异均无显著性 (χ2 =0 .49,1.93,P>0 .0 5 )。 4结论 rt- PA是治疗 AMI的一种安全、有效的纤溶剂 ,临床上可以推广应用
1 Objective To observe the effect of recombinant tissue plasminogen activator (rt-PA) on acute myocardial infarction (AMI). 2 Methods According to the different thrombolytic drugs will be 94 cases of AMI patients were divided into two groups. Patients in rt-PA group (n = 55) received a first dose of rt-PA 10-15 mg and the remaining 35-40 mg in a 30 min pump with a micropump, followed by a pump of 50 mg in 60 min, Special circumstances may be appropriate to increase the amount. In the uric acid oxidase (UK) group (39 cases), UK 1.5 million units were pumped within 30 mins and heparin was not routinely applied. 3 Results rt-PA group recanalization rate was 80.0%, UK group was 56.4%, the difference between the two groups was significant (χ2 = 6 .0 7, P <0. The incidence of reperfusion arrhythmia was 65.5% in rt-PA group and 43.6% in UK group (χ2 = 4.44, P <0.05). The incidences of mild hemorrhage in rt-PA and UK groups were 12.7% and 17.9%, respectively, and the 30-day hospital stay was 1.8% and 7.7% respectively, with no significant difference between the two groups (χ2 = 0. 49, 1.93, P> 0.05). 4 Conclusion rt-PA is a safe and effective treatment of AMI fibrinolysis, the clinical application can be promoted