摘要
目的对比不同时段应用低分子量肝素钙对瑞替普酶治疗急性心肌梗死的效果。方法将91例应用瑞替普酶静脉溶栓治疗的急性心肌梗死患者，按随机数字表法分为A组（30例）、B组（30例）、C组（31例），并且分别于瑞替普酶静脉溶栓后即刻、6h、12h开始应用低分子量肝素钙，以上三组患者均维持每12h5000U低分子量肝素钙腹壁皮下注射，治疗7～10d。观察三组冠状动脉再通率、急性期并发症及不良反应发生情况。结果A、B、C组冠状动脉再通率分别为76．7％（23／30）、96．7％（29／30）、74．2％（23／31），B组冠状动脉再通率显著高于A、C组，差异有统计学意义（P〈0．05）。B组急性期并发症及不良反应发生率为33．3％（10／30），显著低于A组[70．0％（21／30）]和C组[61．3％（19／31）]（P〈0．05）。结论在瑞替普酶治疗急性心肌梗死患者中，静脉溶栓后6h开始联合应用低分子量肝素钙，可显著提高冠状动脉再通率，减少并发症和不良反应。
Objective To compare the effect of applying low molecular weight heparin calcium in different periods of reteplase for acute myocardial infarction （AMI）. Methods Ninety-one cases of AMI were divided into group A（30 cases）,group B（30 cases） and group C （31 cases） by random digits table. The patients in three groups were given reteplase intravenous thrombolysis, and 5000 U low molecular weight heparin calcium was abdominal wall subcutaneous injections once 12 h at intravenous thrombolysis immediately （group A）,after intravenous thrombolysis 6 h （group B） and 12 h （group C）. They all were treated for 7-10 d. The rate of coronary artery recanalization, acute phase complication and adverse reaction were compared among three groups. Results The rate of coronary artery recanalization in group A, B and C was 76.7% （23/30）, 96.7% （29/30）, 74.2% （ 23/31 ） respectively.The rate of coronary artery recanalization in group B was significantly higher than that in group A and C （P 〈 0.05 ）. The rate of acute phase complication and adverse reaction in group B [33.3%（10/30） ] was significantly lower than that in group A and C [70.0% （21/30） and 61.3% （19/31）] （P 〈 0.05）. Conclusions After reteplase intravenous thrombolysis in 6 h, applying low molecular weight heparin calcium can significantly improve the rate of coronary artery recanalization and reduce the rate of acute phase complication and adverse reaction.
出处
《中国医师进修杂志》
2012年第6期4-6,共3页
Chinese Journal of Postgraduates of Medicine
基金
广东省东莞市科技计划（200910515000025）
关键词
肝素
低分子量
心肌梗死
瑞替普酶
静脉溶栓
Heparin,low-molecular-weight
Myocardial infarction
Reteplase
Intravenous thrombolysis
