瑞通立与普佑克溶栓治疗急性ST段抬高型心肌梗死的疗效及对心功能的影响研究-现代医学

瑞通立与普佑克溶栓治疗急性ST段抬高型心肌梗死的疗效及对心功能的影响研究

单位：内蒙古医科大学第三附属医院心内科, 内蒙古包头 014000

关键词：急性ST段抬高型心肌梗死重组人尿激酶原重组人组织型纤溶酶原激酶衍生物尿激酶血管再通心功能

分类号：R542.2

出版年·卷·期（页码）：2017·36·第六期（789-794）

摘要：

目的：对比研究瑞通立与普佑克静脉溶栓治疗急性ST段抬高型心肌梗死（STE-AMI）的临床疗效及对患者心功能的影响。方法：将126例STE-AMI患者随机分为瑞通立组、普佑克组和尿激酶组（每组42例），分别应用瑞通立、普佑克与尿激酶静脉溶栓治疗。对比三组的血管再通率、心功能指标变化及并发症发生率。结果：普佑克组的再通率及完全再通率分别为76.19%、64.29%，与瑞通立组的78.57%、66.67%比较差异无统计学意义（P>0.05），但均显著高于尿激酶组的52.38%、42.86%（P<0.05）；治疗7d后，普佑克组与瑞通立组的LVEDD、LVEF、E/A值、E峰值均较治疗前显著提高（P<0.05），两组间比较差异无统计学意义（P>0.05），但改善幅度均显著优于尿激酶组（P<0.05）；普佑克组的出血并发症发生率为2.38%，显著低于瑞通立组的14.29%和尿激酶组的16.67%（P<0.05）；普佑克组与瑞通立组的不良心脏事件发生率分别为4.76%、7.14%，组间比较差异无统计学意义（P>0.05），但均显著低于尿激酶组的28.57%（P<0.05）。结论：瑞通立与普佑克溶栓的成功率均优于尿激酶，两药在STE-AMI静脉溶栓中的血管再通率及完全再通率相当，均能够有效改善患者的心功能，但普佑克的出血风险更低，可作为早期溶栓的首选药物。

Objective: To compare the clinical efficacy and influence on heart function of Ruitongli and Prourokinase in patients with ST-segment elevation acute myocardial infarction (STE-AMI). Methods: A total of 126 patients with STE-AMI were collected and randomly divided into three groups:Ritongli group, prourokinase group and urokinase group (42 in each group). The Ritongli group received Ritongli,,the Prourokinase group Prourokinase, Urokinase group Urokinase.The recanalization rate,changes of heart function indicators and complication rate were compared between the three groups. Results: The rates of recanalization and complete recanalization were 76.19% and 64.29% in Prourokinase group, they were 78.57%,66.67% in Ritongli group, showing no significant differences (P>0.05),however they all were significantly higher than 52.38% and 42.86% in the Urokinase group (P<0.05); After 7 days of treatment, the LVEDD, LVEF, E/A and E peak values in Prourokinase group and Ritongli group were significantly higher than those in the pre-treatment (P<0.05), but the differences between the two groups were not significant (P>0.05),and the improvement degrees were significantly better than Urokinase group (P<0.05); The incidence of bleeding in Prourokinase group was 2.38%, significantly lower than 14.29% in Ritongli group and 16.67% in Urokinase group (P<0.05);The incidence of adverse cardiac events in Prourokinase group and Ritongli group was 4.76% and 7.14%%, the difference was not significant (P>0.05),but they were significantly lower than 28.57% in the Urokinase group (P<0.05). Conclusion: Ritongli and Prourokinase have a higher success rate of thrombolysis compared with Urokinase, the two drugs can achieve similar recanalization rate and complete recanalization rate at early intravenous thrombolysis for STE-AMI, as well as effectively improve the heart function of AMI patients, while Prourokinase has a lower bleeding risk,so it is the first choice for early thrombolysis.

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