瑞替普酶与尿激酶治疗急性心肌梗死的疗效比较

目的：观察瑞替普酶与国产尿激酶治疗急性心肌梗死（AMI）的临床疗效和副作用。方法：将172例AMI病人随机分两组。瑞替普酶组94例，给予瑞替普酶20mU，分2次，每次10mU，间隔30min静脉推注；尿激酶组78例，先予尿激酶100×10^4U静脉推注，后予100×10^4U溶于5％GS150ml内，30min内静脉滴注。两组均用注射用低分子肝素皮下注射，其余治疗也相同。结果：瑞替普酶组与尿激酶组的血管开通率、开通时间分别为85％与63％；（0．80±0．52）h与（1．36±0．55）h（P〈0．05）；CK和CK-MB峰值及峰值时间：两组差异无显著性（P〉0．05）；副作用：轻度出血率在瑞替普酶组与尿激酶组分别为4％与9％（P〈0．05）。结论：瑞替普酶治疗AMI的疗效优于尿激酶，且副作用小。

Comparing Efficacy of Reteplase with Urokinase on Acute Myocardial Infarction

Objective： To observe the efficacy and side-effects of Reteplase and Urokinase in treating the patients with acute myocardial infarction （AMI）. Methods： 172 patients with AMI was randomly divided into Reteplase group （R group,n=94） and Urokinase group（U group,n=78）. In R group, 20MU of Reteplase was given with 10MU each, 30min. interval in intravenous injection. In U group, Urokinase was given first with 100×10^4U in injection and then 100×10^4 U in 5 %G.S 150ml intravenous drip. Treatment was the same for the other two groups, excepting the use of heparin. Results： The patency rates and time of patency in R group and U group were 85% vs 63%（P〈0.05 ）, （0.80±0.52） h vs （1.36 ±0.55 ） h （P〈 0.05 ） respectively. Mild bleeding was 4% vs 9% （P〈0.05）. There was no difference in peak values of CK, CK-MB and their times between the two groups （P〉0.05）. Conclusions： The efficacy of Reteplase was better than that of Urokinase with fewer side-effects.