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目的探讨分析依诺肝素不同用法在瑞替普酶治疗急性心肌梗死中的效果。方法 120例急性心肌梗死患者,将所选患者按给药方式分为A、B、C三组,每组40例。三组均采用依诺肝素联合瑞替普酶进行治疗,但依诺肝素药物的给药方式存在差异,A组患者在溶栓前静脉推注30 mg,溶栓结束后皮下注射1 mg/kg;B组患者在溶栓前皮下注射1 mg/kg;C组患者在溶栓结束后皮下注射1 mg/kg,患者均12 h注射1次。所有患者均持续治疗7 d。比较三组患者临床治疗效果。结果比较三组患者治疗60 min后再通状况,A组为82.5%,B组为62.5%,C组为60.0%,三组比较,A组明显高于其他两组,差异具有统计学意义(P<0.05);B、C组比较,差异无统计学意义(P>0.05);三组治疗90 min再通状况比较,差异无统计学意义(P>0.05)。三组患者并发症总发生率分别为12.5%、10.0%、10.0%,比较差异无统计学意义(P>0.05)。结论临床中,治疗急性心肌梗死,采用瑞替普酶进行治疗前,可采用溶栓静脉给药,依诺肝素30 mg负荷量,使冠状动脉再通时间缩短,且安全可靠。
Objective To investigate the effect of different enoxaparin in reteplase treatment of acute myocardial infarction. Methods A total of 120 patients with acute myocardial infarction were divided into three groups according to the mode of administration: A, B and C, 40 cases in each group. All three groups were treated with enoxaparin plus reteplase, but there were differences in the administration of enoxaparin. Patients in group A received intravenous bolus injection of 30 mg before thrombolysis and subcutaneous injection of 1 mg / kg after thrombolysis . Patients in group B received subcutaneous injection of 1 mg / kg before thrombolysis. Patients in group C received subcutaneous injection of 1 mg / kg at the end of thrombolytic therapy. All patients were injected once for 12 hours. All patients were treated for 7 days. Comparison of three groups of patients with clinical treatment. Results The reoperation status of the three groups of patients after treatment for 60 min was 82.5% in A group, 62.5% in B group and 60.0% in C group. The A group was significantly higher than the other two groups (P <0.05), the difference was statistically significant P <0.05). There was no significant difference between group B and group C (P> 0.05). There was no significant difference in the recanalization status between the three groups at 90 min (P> 0.05). The overall incidence of complications in the three groups were 12.5%, 10.0% and 10.0%, respectively, with no significant difference (P> 0.05). Conclusions In clinical treatment of acute myocardial infarction, intravenous thrombolytic therapy can be used before the treatment with reteplase, enoxaparin 30 mg load, the coronary recanalization time is shortened, and safe and reliable.