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目的观察重组人尿激酶原对ST段抬高型急性心肌梗死患者血浆纤溶因子及血管再通的影响。方法将50例急性ST段抬高性心肌梗死患者按照入院顺序随机分为观察组和对照组各25例。观察组给予重组人尿激酶原治疗,对照组给予尿激酶治疗。观察比较2组患者的血管再通情况、ST段回落情况、人组织纤溶酶原激活物(t-PA)、人纤溶酶原激活物抑制剂(PAI-1)的水平变化、患者的心脏事件、出血程度及不良反应发生情况。结果观察组的血管再通率为80.0%明显高于对照组的48.0%(P<0.05)。观察组患者ST段回落情况优于对照组(P<0.05)。治疗前2组t-PA、PAI-1水平比较差异无统计学意义(P>0.05)。治疗后2组t-PA水平升高,PAI-1水平降低,且观察组变化幅度均大于对照组(P<0.05)。观察组患者心脏事件发生率明显少于对照组,出血程度轻于对照组(P<0.05)。观察组不良反应发生率为8.0%低于对照组的40.0%(P<0.05)。结论重组人尿激酶原能够有效治疗ST段抬高性的心肌梗死,提高血管再通率,促进心电图ST段的回落,可在临床推广应用。
Objective To observe the effect of recombinant human urokinase on plasma fibrinolysis and vascular recanalization in patients with ST-segment elevation acute myocardial infarction. Methods Fifty patients with acute ST-segment elevation myocardial infarction were randomly divided into observation group and control group according to the order of admission. The observation group was given recombinant human urokinase and the control group was treated with urokinase. The levels of recanalization, ST-segment depression, t-PA and PAI-1 in the two groups were observed and compared. Heart attack, bleeding and adverse reactions. Results The vascular recanalization rate in the observation group was 80.0%, which was significantly higher than that in the control group (48.0%, P <0.05). ST-segment drop in the observation group was better than that in the control group (P <0.05). The levels of t-PA and PAI-1 in the two groups before treatment had no significant difference (P> 0.05). The levels of t-PA and PAI-1 decreased in both groups after treatment, and the changes in the observation group were greater than those in the control group (P <0.05). The incidence of cardiac events in observation group was significantly less than that in control group, and the degree of bleeding was lighter than that in control group (P <0.05). The incidence of adverse reactions in the observation group was 8.0% lower than that in the control group (40.0%, P <0.05). Conclusions Recombinant human pro-urokinase can effectively treat ST segment elevation myocardial infarction, improve the recanalization rate and promote the fall of ST segment of ECG, which can be widely used in clinic.