关键词: 急性心肌梗死, 溶栓, 纤溶系统, 重组人尿激酶原, 尿激酶

Abstract:

Objective To observe the effects of Pro-UK on coagulation and fibrinolysis compared with UK in patients with acute myocardial infarction. Methods 114 patients with acute myocardial infarction who accorded with the indications of thrombolytic therapy were randomly divided into four groups (Pro-UK 30 & 40 mg: 26 cases; 50 mg: 29 cases ; 60 mg: 28 cases; UK: 31 cases). Plasminogen(PLG), D- dimer (D-D), tissue-type Plasminogen Activator(t-PA), Plasminogen Activator Inhibitor(PAI) and fibrinogen (Fib) were measured immediately before and 2,24,48 h after thrombolysis initiation. The effect of the thrombolytic therapy and patient's bleeding complications were also observed. Results 2 h after thrombolytic therapy, PLGand PAI of each group were significantly lower(P<0.01), D-Dand t-PAwere significantly higher than that before thrombolytic therapy in each group(P<0.01); Fib of UK group 2 h after therapy became significantly lower than that before therapy(P<0.01), but the changes in Pro-UK groups were not significant, all changes recovered 24 h after therapy; 2 h after thrombolytic therapy, Fib of Pro-UKgroups were significantly higher than that of UKgroup(P<0.01), the results at other times were no significantly different; there were no significant differences between each group in terms of therapeutic effects and bleeding syndrome; 2 h after therapy, PAI of reperfusion group was significantly lower than that of non-reperfusion group(P<0.01), other results were not significantly different. Conclusion There is significant effect on the activation of systemic fibrinolysis in UKgroup, but Pro-UKhas little effect on the systemic fibrinolysis.

Key words: acute myocardial infarction, thrombolysis, fibrinolysis, Pro-UK, UK