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目的研究瑞替普酶溶栓在治疗急性st段抬高性心肌梗死(STEMI)患者中的临床价值。方法选取本院收治的STEMI患者90例,随机分为两组。观察组45例,静脉滴注瑞替普酶(rt-PA)溶栓治疗;对照组45例,静脉推注阿替普酶(t-PA)溶栓治疗。观察两组患者溶栓治疗的临床效果及并发症情况,作出对比分析。结果两组在胸痛-就诊-溶栓治疗时间以及再通时间上均无显著性差异(P>0.05)。经溶栓治疗后,观察组50%ST段回落、完全回落率均高于对照组,但无统计学意义;观察组心律失常发生率为28.9%,低于对照组的33.3%,统计无显著性差异(P>0.05);但比较不良反应,观察组的发生率为6.67%(3/45),明显低于对照组的15.6%(7/45),差异有统计学意义(P<0.05)。结论瑞替普酶和阿替普酶均能有效治疗ste Mi,但瑞替普酶不良反应发生率低,安全性好,对于STEMI疗效的改善有重要价值。
Objective To investigate the clinical value of reteplase thrombolysis in the treatment of patients with acute st-segment elevation myocardial infarction (STEMI). Methods 90 STEMI patients admitted to our hospital were randomly divided into two groups. The observation group consisted of 45 patients. Intravenous infusion of reteplase (rt-PA) was used for thrombolysis. In the control group, 45 patients were treated with intravenous infusion of alteplase (t-PA). The clinical effects and complications of thrombolytic therapy in both groups were observed and compared. Results There was no significant difference between the two groups in the time of chest pain - treatment - thrombolytic therapy and the reopening time (P> 0.05). After thrombolytic therapy, 50% ST segment of the observation group dropped back and the complete drop rate was higher than that of the control group, but no statistical significance; the incidence of arrhythmia in the observation group was 28.9%, which was lower than 33.3% in the control group (P <0.05). However, the adverse reaction rate was 6.67% (3/45) in the observation group and 15.6% (7/45) in the control group, with significant difference (P <0.05 ). Conclusion Both reteplase and alteplase can effectively treat ste Mi, but the incidence of adverse reactions of reteplase is low and the safety is good, which is of great value for the improvement of STEMI.