瑞替普酶在低体重急性心肌梗死患者中减量应用疗效观察
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摘要
目的:观察瑞替普酶在低体质量急性心肌梗死患者中减量应用的疗效。方法:选取2012年4月—2015年3月我院收治的43例低体质量(<50 kg)急性心肌梗死(AMI)患者,按随机数字表法分为两组,试验组(21例)给予减量瑞替普酶(12 mg)进行静脉溶栓,对照组(22例)给予常规剂量(18 mg)溶栓。比较两组溶栓再通情况、心肌酶平均含量及并发各种出血情况。结果:两组溶栓开始后0.5,1,1.5,2 h再通率比较,差异无统计学意义(P> 0.05);两组6～12 h肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白(CTn)I、CTnT平均含量比较,差异无统计学意义(P> 0.05);试验组并发各种出血的发生率明显低于对照组,差异有统计学意义(P <0.05)。结论:瑞替普酶在低体质量急性心肌梗死患者中减量应用对血管溶栓再通率无明显影响,但可显著降低各种出血的发生率。
Objective: To observe the efficacy of decrement reteplase in patients with low-body mass acute myocardial infarction. Methods: 43 patients with low-body mass(<50 kg) acute myocardial infarction(AMI) admitted to our hospital from April 2012 to March 2015 were selected and randomly divided into two groups. The patients in the experimental group(21 cases) were given decrement reteplase(12 mg) for intravenous thrombolysis, and the patients in the control group(22 cases) were given a conventional dose of the drug(18 mg) for thrombolysis. The recanalization of thrombolysis, the average content of myocardial enzymes and the complications of various hemorrhage conditions were compared between the two groups. Results: There was no statistically significant difference in recanalization rate between the two groups 0.5, 1, 1.5 and 2 h after thrombolysis(P>0.05). There were no statistically signi?cant differences in the average contents of 6-12 h creatine kinase isoenzyme(CK-MB), cardiac troponin(CTn) I and CTnT between the two groups(P>0.05). The incidence of various hemorrhage complications in the experimental group was signi?cantly lower than that in the control group, and the difference was statistically signi?cant(P<0.05). Conclusion:The decrement reteplase has no signi?cant effect on the recanalization rate of vascular thrombolysis in patients with lowgrade acute myocardial infarction, but can signi?cantly reduce the incidence of various hemorrhage conditions.
Objective: To observe the efficacy of decrement reteplase in patients with low-body mass acute myocardial infarction. Methods: 43 patients with low-body mass(<50 kg) acute myocardial infarction(AMI) admitted to our hospital from April 2012 to March 2015 were selected and randomly divided into two groups. The patients in the experimental group(21 cases) were given decrement reteplase(12 mg) for intravenous thrombolysis, and the patients in the control group(22 cases) were given a conventional dose of the drug(18 mg) for thrombolysis. The recanalization of thrombolysis, the average content of myocardial enzymes and the complications of various hemorrhage conditions were compared between the two groups. Results: There was no statistically significant difference in recanalization rate between the two groups 0.5, 1, 1.5 and 2 h after thrombolysis(P>0.05). There were no statistically signi?cant differences in the average contents of 6-12 h creatine kinase isoenzyme(CK-MB), cardiac troponin(CTn) I and CTnT between the two groups(P>0.05). The incidence of various hemorrhage complications in the experimental group was signi?cantly lower than that in the control group, and the difference was statistically signi?cant(P<0.05). Conclusion:The decrement reteplase has no signi?cant effect on the recanalization rate of vascular thrombolysis in patients with lowgrade acute myocardial infarction, but can signi?cantly reduce the incidence of various hemorrhage conditions.
引文
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[2]胡大一.心血管疾病防治指南和共识2008[M].北京:人民卫生出版社,2008:183-203.
[3]Tjandrawidjaja MC,Fu Y,westerhout CM,et al.Resolution of ST-segment depression:A new prognostic marker in ST-segment elevation myocardial infarction[J].Eur Heart J,2010,31(5):573-581.
[4]Halvorsen S,Huber K.Fibrinolytic treatment of ST-elevation myocardial infarction.Update2014[J].Hamostase ologie,2014,34(1):47-53.
[5]Solhpour A,Yusuf SW.Fibrinolytic therapy in patients with ST-elevation myocardial infarction[J].Expert Rev Cardiovasc Ther,2014,12(2):201-215.
[6]Jamialahmadi O,Fazeli A,Hashemi-Najafabadi S,et al.Anovel clot lysis assay for recombinant plasminogen activator[J].Biotechnol Lett,2015,37(3):593-600.
[7]急性ST段抬高心肌梗死溶栓治疗中国专家共识组.急性ST段抬高心肌梗死溶栓治疗的中国专家共识(修订版)[J].中华内科杂志,2008,47(2):170-174.