摘要
目的探讨瑞替普酶联合低分子肝素治疗ST段抬高型急性心肌梗死(STEAMI)的安全性与有效性。方法将112例STEAMI患者随机分为治疗组56例,对照组56例,均经瑞替普酶静脉溶栓后,治疗组给予低分子肝素5000U皮下注射,2次/d;对照组给予普通肝素静脉滴注,24h后改为低分子肝素5000U皮下注射,2次/d。观察并比较两组的临床再通率、血管开通率、急性期并发症等。结果治疗组与对照组相比,临床再通率(87.5%vs83.9%)、血管再通率(76.8%vs75.0%)高,但差异均无统计学意义(P>0.05)。治疗组出血发生率低于对照组(8.9%vs19.6%),差异有统计学意义(P<0.05);两组的死亡率、心源性休克及严重心律失常发生率间差异均无统计学意义(P>0.05)。结论瑞替普酶联合低分子肝素用于STEAMI再灌注治疗安全、有效、方便。
Objective To evaluate the efficacy and safety of using reteplase for intravenous thrombolysis therapy and low molecular weight heparin （LMWH） instead of unfractionated heparin （UFH） for anti -coagulation therapy on the patients with ST - segment elevation acute myocardial infarction （STEAMI） . Methods 112 AMI patients after thrombolytic therapy with reteplase were randomly divided into two groups： treatment group （LMWH 5 000 U, subcutaneously, Q 12 h） and control group （24 -hour continuous heparin infusion, then changed to LMWH 5 000 U, subcutaneously, Q 12 h） . The clinical repatency, infarction related artery （IRA） repateney, major adverse coronary events, hemorrhage and adverse events were observed. Results The clinical repatency rate （87.5% vs 83.9% ） and the IRA repatency rate （76. 8% vs 75.0% ） were higher in treatment group than in control group, but there was no significant difference between the two groups （ P 〉 0. 05 ）. The hemorrhage rate was lower in treatment group than in control group （8.9% vs 19. 6% , P 〈 0. 05） . The rate of death, cardiac shock and serious cardiac arrhythmias showed no significant difference between the two groups （P 〉 0. 05 ）. Conclusion Our results suggest that it is safe, efficient and convenient to use reteplase and LMWH for reperfusion therapy on patients with acute myocardial infarction.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第19期2109-2110,共2页
Chinese General Practice
关键词
急性心肌梗死
瑞替普酶
肝素
低分子量
再灌注
Acute myocardial infarction
Reteplase
Heparin, low molecular weight
Reperfusion
