瑞替普酶与尿激酶对急性心肌梗死患者院内治疗有效性及安全性的多中心随机对照研究

发布时间：2018-06-02 03:24

本文选题：瑞替普酶 + 尿激酶　；参考：《中国动脉硬化杂志》2016年11期

【摘要】：目的对比观察瑞替普酶与尿激酶用于急性ST段抬高型心肌梗死患者溶栓治疗的疗效及安全性。方法2014年河南省34家医院参加本研究,356例急性ST段抬高型心肌梗死患者符合入排标准入选,随机分组给予瑞替普酶(n=178)或尿激酶(n=178)溶栓治疗。溶栓后通过监测临床症状、心电图、心肌酶及心律变化判断溶栓再通率,并观察住院期间心血管事件及出血事件的发生率,出血事件采用全球梗死相关动脉开通策略(GUSTO)分级。结果瑞替普酶组溶栓后2 h临床标准判断血管再通率为88.6%(156/176),尿激酶组为51.1%(91/178)(P0.001),瑞替普酶组血管再通时间较尿激酶组平均提早18 min(IC95%11~25)(P0.001)。瑞替普酶组溶栓后住院期间死亡率为0.6%(1/176),尿激酶组为3.4%(6/178)(P0.05)。瑞替普酶组与尿激酶组均无GUSTO严重出血事件发生,GUSTO中度出血率分别为1.7%(3/176)、0.0%(0/178)(P0.05);GUSTO轻度出血率分别为6.8%(12/176)、2.8%(5/178)(P0.05)。结论与尿激酶相比,瑞替普酶具有更高的血管再通率,不良反应少,是一种安全有效的溶栓药物。
[Abstract]:Objective to compare the efficacy and safety of reteprase and urokinase in thrombolytic therapy in patients with acute St segment elevation myocardial infarction. Methods in this study, 356 patients with acute ST-segment elevation myocardial infarction were enrolled in this study in 2014. Patients with ST-segment elevation myocardial infarction were randomly divided into two groups. After thrombolysis, the recanalization rate of thrombolysis was determined by monitoring clinical symptoms, electrocardiogram, myocardial enzyme and cardiac rhythm changes, and the incidence of cardiovascular events and bleeding events during hospitalization were observed. The bleeding events were classified by global infarct-related artery opening strategy (GUSTOL). Results the rate of recanalization was 88.6 / 176 in the reteprase group and 91.1 / 178U / P 0.001 in the urokinase group, respectively. The mean recanalization time of the retipase group was 18 min(IC95 / 25U / P 0.001 earlier than that of the urokinase group. After thrombolysis, the mortality rate during hospitalization in the retipase group was 0.6 / 176U, and in the urokinase group it was 3.4R / 178U / P 0.05g. The moderate bleeding rate of GUSTO in the reteprase group and urokinase group was 1.7% and 0.00 / 1786% respectively. The mild bleeding rate of GUSTO was 6.810 / 12176g / 2.8g / 178P 0.05, respectively. Conclusion compared with urokinase, reteprase is a safe and effective thrombolytic drug with higher vascular recanalization rate and less adverse reactions.
【作者单位】：郑州大学人民医院心血管内科;郑州大学第一附属医院心血管内科;北京大学人民医院心血管内科;
【基金】：贵州益佰医药有限责任公司提供资金支持
【分类号】：R542.22

【相似文献】