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目的 :为比较小剂量重组组织型纤溶酶原激活剂 (rt-PA)及尿激酶 (UK)静脉溶栓辅以阿司匹林及肝素对急性心肌梗死的效果及其副作用。方法 :对急性心肌梗死患者发病 6h内者 ,3 1例给予静脉rt -PA ;3 2例静脉内UK溶栓辅以静脉肝素及阿司匹林治疗。结果 :rt -PA组、UK组临床血管再通率分别为 80 6%与 5 6 3 % ( P <0 .0 5 ) ,前者消化道与泌尿道出血并发症为9 6% ,而后者为 0 (P <0 0 5 )。结论 :本研究提示静脉rt -PA溶栓血管再通率显著高于静脉UK ,但出血并发症的发生rt -PA组显著高于UK组。
Objective: To compare the effects and side effects of intravenous thrombolysis with low dose recombinant tissue plasminogen activator (rt-PA) and urokinase (UK) supplemented with aspirin and heparin on acute myocardial infarction. Methods: Intravenous rtPA was given to 31 patients with acute myocardial infarction within 6 hours and 32 intravenous UK thrombolysis with intravenous heparin and aspirin. Results: The rates of clinical recanalization in rt-PA group and UK group were 80.6% and 56.3% respectively (P <0.05). The former had complication of gastrointestinal and urinary tract bleeding of 96%, while the latter was 0 (P <0 0 5). CONCLUSIONS: This study suggests that the rate of recanalization of venous rt-PA thrombolysis is significantly higher than that of venous UK, but the incidence of bleeding complications was significantly higher in rt-PA group than in UK group.