基层医院急诊室内使用瑞替普酶与小分子肝素治疗急性ST段抬高型心肌梗死的疗效评价-论文.pdf

《基层医院急诊室内使用瑞替普酶与小分子肝素治疗急性ST段抬高型心肌梗死的疗效评价-论文.pdf》由会员上传分享，免费在线阅读，更多相关内容在应用文档-天天文库。

1、·12·中国实用医药2014年4月第9卷第ll期ChinaPracMed，Al3r2014，Vo[．9，No．11基层医院急诊室内使用瑞替普酶与小分子肝素治疗急性ST段抬高型心肌梗死的疗效评价林惠文李国明陈荣健【摘要】目的比较瑞替普酶(rPA)与小分子肝素(依诺肝素)对急性sT段抬高型心肌梗死(STEMI)患者急诊静脉溶栓治疗的临床疗效。方法观察2008年11月一2010年10月间在本院急诊室内接受rPA或尿激酶溶栓并辅助普通肝素或依诺肝素抗凝治疗的72例STEMI患者，在血管再通率、心脏功能恢复程度、出血不良反应及预后等方面的差异。结果C组(rPA+肝素)

2、和D组(rPA+依诺肝素)溶栓再通率均明显高于A组(尿激酶+肝素)、B组(尿激酶+依诺肝素)，且平均再通时间也明显缩短(P<0．05)。心脏彩超提示，治疗3个月后c、D组心脏功能的恢复更为明显。此外，B、D组轻度出血的发生率比A、c组降低<0．05)。结论rPA辅助依诺肝素适合基层急诊室内进行STEMI的静脉溶栓治疗。【关键词】瑞替普酶；依诺肝素；急性sT段抬高型心肌梗死；基层急诊EfficacyofreteplaseandlowmolecularweightheparininpatientswithSTsegmentelevationmyocardiali

3、nfarctionintheemergencydepartmentofprimaryhospitalLINHui—wen,LiGuo-ming,ChenRong-jianDepartmentofEmergency,JiangmenCentralHospital,Jiangmen,529070,China【Abstract】ObjectiveToobservetheclinicaleficacyofintravenousthrombolytictherapyusingreteplase(rPA)andanticoagulanttreatmentusinglow

4、molecularweightheparin(Enoxaparin)inpatientswithSTsegmentelevationmyocardialinfarction(STEMI)intheemergencydepartmentofprimaryhospita1．MethodsSeventy-twopatientswithSTEMIadmittedinourdepartmentfromNovember2008toOctober2010andreceivedrPAorurokinase(UK)accompanyingwithheparinorEnoxap

5、arin．Thepatencyofinfarct-relatedcoronaryarteryassessedbyunifiedclinicalcriteriaorangiography，recoveryofheartfunctionanalyzedbyechocardiography，adverseevents，va~ouscomplicationsofmyocardialinfarctionandmortalitywereobserved．ResultsGroupC(rPA+heparin)andgroupD(rPA+Enoxapafin)showedth

6、ehigherratesofpatencyandfasterrecanalizationtimeininfarct—relatedcoronaryarterythangroupA(UK+heparin)andgroupB(UK+Enoxaparin)，respectively(P<0．05)．TheefectonrecoveryofheartfunctionwasgreateringroupCandDbyrPA．Additionally，lesseventsofhemorrhageoccurredingroupBandD’<0．o5)．ConclusionR

7、eteplaseaccompanyingwithEnoxaparinisaneffective，reliableandsafethrombolytictherapyforthetreatmentofSTsegmentelevationmyocardialinfarctionintheemergencydepartmentofprimaryhospita1．【Keywords】Reteplase；Enoxaparin；STsegmentelevationmyocardialinfarction；Emergencydepartmentofprimaryhospi

8、tal急性心肌梗死fAMI)是严重危害人类健康和生命