急诊应用阿替普酶与重组链激酶静脉溶栓治疗急性心肌梗死疗效观察

武希梅

(内蒙古自治区呼和浩特市第一医院内蒙古呼和浩特010000)

[摘要]①目的观察急诊使用阿替普酶与重组链激酶静脉溶栓治疗ST段抬高型急性心肌梗死(AMI)的临床疗效。②方法210例ST段抬高型AMI患者,按入院时间分为A、B两组，采用回顾性分析方法。两组患者在性别、年龄、合并高血压、合并糖尿病等一般状况上比较，差异无统计学意义(P>0.05)。A组使用重组链激酶，B组使用阿替普酶，比较两组患者90min内的冠状动脉血管再通率、脑出血发生率及在院病死率。③结果A组冠状动脉再通率为70%，脑出血发生率为1.11%，在院病死率为4.44%；B组冠状动脉再通率为85%，脑出血发生率为4.17%，在院病死率为5.83%。B组冠状动脉再通率明显高于A组，差异有统计学意义；B组脑出血发生率及在院病死率均高于A组，但差异无统计学意义。④结论阿替普酶用于急诊静脉溶栓治疗ST段抬高型AMI冠状动脉再通率高于重组链激酶，而脑出血率和在院病死率与重组链激酶相当。

[关键词]阿替普酶重组链激酶静脉溶栓心肌梗死

[中图分类号]R 542.2[文献标识码]A

【作者简介】武希梅(1979-)，女，主治医师。研究方向：急危重症抢救。

Observation on curative effect of intravenous thrombolysis theroply with alteplase and recombinant streptokinase for acute myocardial infarction in clinicalWuXimei(EmergencyDepartmentInnerMongoliaHohhotFirstHospitalHohehotNeimenggu010030,China)

ABSTRACT[]ObjectiveTo observe the curative effect of intravenous thrombolysis theroply with alteplase and recombinant streptokinase for Acute ST segment elevation myocardial infarction(STAMI) in emergency.Methods 90 cases of STAMI patients who were treated between January 2010 and December 2010 collected, into group A,collected 120 cases of STAMI patients who were trested between January 2014 and December 2014 into group B,using retrospective analysis method,patients in group A were treated with recombinant streptokinase,but patiants in group B received alteplase thrombolysis treatment,compared the vascular re-pass rate of coronary arteries within 90 minates,the complication rate of cerebral hemorrhage and the mortality rate in hospital.ResultsThe vascular re-pass rate of coronary arteriey was 70% in group A but 85% in group B,B group was obviously higher than of group A,The difference compared was statistically significant,the complication rate of cerebral hemorrhage was 1.11% in group A but 4.17% in group B,the mortality rate in hospital was 4.44% in group A but 5.83% in group B,in these two,B group were higher than that of group A,but there was no statistically significant difference comparison.ConclusionThe cu rative effect of intravenous thrombolysis theroply of alteplase is better than of recombinant streptokinase for Acute ST segment elevation myocardial infarction,It is worth popularization in clinical.

[KEYWORDS]Alteplase.Recombinant streptokinase.Intravenous thrombolysis.Myocardial infarction

ST段抬高型急性心肌梗死(AMI)为急诊科最常见的心血管急症之一，具有急性起病、病情波动大、进展迅速的特点，如不能尽早紧急开通闭塞的冠状动脉血管，恢复冠状动脉血流，患者极易在短时间内发生严重心律失常、心力衰竭、心源性休克、心脏破裂等并发症而危及生命[1]。静……