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目的对比小剂量重组组织型纤溶酶原激活剂(rt-PA)与尿激酶(UK)溶栓治疗急性心肌梗死(AMI)的疗效。方法将急诊入院的急性心肌梗死患者90例随机分为甲、乙两组,甲组(50例)用rt-PA治疗;乙组(41例)用UK治疗。甲组入院后即给予rt-PA 50mg静脉注射用输液泵或微量泵在60min内注完。乙组先静注UK 150万U,30min内滴完。两组患者溶栓后均继用肝素静脉滴注维持3d以上。结果 90min再通率,甲组为80.6%(25/31),乙组为56.3%(18/32),两组比较差别有统计学意义(P<0.05)。甲组出血等并发症少于乙组(10.0%与17.5%)。结论小剂量rt-PA加速溶栓疗法治疗急性心肌梗死效果优于尿激酶溶栓疗法,且副反应少,值得推广。
Objective To compare the curative effect of low dose recombinant tissue plasminogen activator (rt-PA) and urokinase (UK) thrombolytic therapy for acute myocardial infarction (AMI). Methods Ninety patients with acute myocardial infarction admitted to the emergency department were randomly divided into two groups: group A (50 cases) treated with rt-PA and group B (41 cases) treated with UK. Group A was given rt-PA 50mg intravenous infusion pump or trace pump within 60min after injection. Group B first intravenous UK 1.5 million U, within 30min drip finished. After thrombolysis in both groups were followed by heparin intravenous infusion to maintain more than 3d. Results The recanalization rate of 90 min was 80.6% (25/31) in group A and 56.3% (18/32) in group B, with a significant difference between the two groups (P <0.05). Group A bleeding complications less than Group B (10.0% and 17.5%). Conclusion Accelerated thrombolytic therapy with low-dose rt-PA is superior to urokinase-thrombolytic therapy in the treatment of acute myocardial infarction with fewer side effects and is worth promoting.