重组链激酶溶栓治疗在急性心肌梗死患者中的应用效果

摘要

目的 分析重组链激酶溶栓治疗在急性心肌梗死(AMI)患者中的应用效果.方法 选取2014年2月-2016年3月百色市人民医院收治的AMI患者50例,根据治疗方法分为对照组和观察组,每组25例.对照组患者给予阿司匹林治疗,观察组患者在对照组基础上给予重组链激酶治疗.比较两组患者治疗前及治疗后2 h、6 h、24 h凝血纤溶指标〔纤维蛋白原(Fg)、D-二聚体、组织型纤溶酶原激活物(t-PA)、组织型纤溶酶原激活物抑制物(PAI)〕及冠状动脉再通率,并记录两组患者治疗期间不良反应/并发症发生情况.结果 时间与方法在Fg、D-二聚体、t-PA、PAI上存在交互作用(P<0.05);时间在Fg、D-二聚体、t-PA、PAI上主效应显著(P<0.05);方法在Fg、D-二聚体、t-PA、PAI上主效应显著(P<0.05);治疗后2 h、6 h、24 h观察组患者Fg、PAI低于对照组,D-二聚体、t-PA高于对照组(P<0.05).观察组患者冠状动脉再通率高于对照组(P<0.05).两组患者治疗期间均未出现严重不良反应/并发症.结论 重组链激酶溶栓治疗能有效改善AMI患者凝血纤溶指标,提高冠状动脉再通率,且安全性较高.%Objective To analyze the application effect of recombinant streptokinase in the thrombolytic therapy for acute myocardial infarction.Methods A total of 50 patients with acute myocardial infarction were selected in the People′s Hospital of Baise from February 2014 to March 2016,and they were divided into control group and observation group according to therapeutic methods,each of 25 cases.Patients of control group received aspirin,while patients of observation group received recombinant streptokinase based on that of control group.Parameters of coagulation-fibrinolysis(including Fg,D-dimer,t-PA and PAI)before, after 2 hours,6 hours and 24 hours of treatment,and recanalization rate of coronary artery were compared between the two groups;incidence of adverse reactions/complications was observed during the treatment.Results There was interaction between time and method in Fg,D-dimer,t-PA and PAI(P<0.05);main effects of time and method were significant in Fg,D-dimer,t-PA and PAI(P<0.05);after 2 hours,6 hours and 24 hours of treatment,Fg and PAI of observation group statistically significantly lower than those of control group,respectively,while D-dimer and t-PA of observation group were statistically significantly higher than those of control group(P<0.05).Recanalization rate of coronary artery of observation group was statistically significantly higher than that of control group(P<0.05).No one of the two groups occurred any serious adverse reactions/complications during the treatment.Conclusion Thrombolytic therapy of recombinant streptokinase can effectively improve the parameters of coagulation-fibrinolysis and recanalization rate of coronary artery,and is safe.