The Clinical Contrast Research For Treating Acute Myocardial Infarction By Reteplase And Urokinase

Coronary heart disease is one of the main diseases which are dangerous to the health of people . Acute myocardial infarction (AMI) is one of acute heart diseases , which is increasing year by year in our country . Myocardium is necrotic because of the lack of blood . On the base of the infarct-related coronary artery , the supply of the blood reduces or intermits sharply , which makes the corresponding myocardium necrotic because of the lack of blood continuously and severly . Clinical investigation has proved that over 80% of AMI which have lifted ST segment is because of the totally block of the coronary artery . The block is caused by thrombolysis . Thrombolytic thrapy has become one of the methods opening the blocked vessel at the early time of AMI . It can rescue the necrotic myocardium , reduce the area of infarction and complication and enhance survival rate . Reteplase (r-PA) , the third-generation thrombolytic drug , is a kind of recombinant tissue plasminogen activator . It is single-chain non-glycosyl-deletion variation of wild-type t-PA , which only contains the K2 area and P area of t-PA . Reteplase (r-PA) reserves the characteristic of t-PA because of the existence of K2 area . The lack of E area makes it have no affinity to fibre protein , so the half period of decadence prolongs (18min) , which is 6 time longer than wild-type t-PA .It also makes the action of thrombolysis 5.3 time stronger than t-PA and serous eliminated rate , 4.3 time lower than t-PA . Animal experiment indicated that r-PA can reach reperfusion faster than t-PA ,SK ,UK and reduce hemorrhage . In comparison with the thrombolytic drugs on the market , r-PA come into effect soon and it can be offered every 30min by injecting directly . It needn't adjust the dosage following weight . So r-PA is more effective at present . Objective:Appraising the clinic effect and the adverse reaction in treating AMI between r-PA and UK . Method:77 patients with AMI during March 2003 to March 2005 were randomized to divide into r-PA group (35 cases) and UK group (42 cases) . The rate of thrombolytic and re-open dead rate during acute phase and adverse effects were observed . Result:The age, sex, infarction region and the time of treatment were not statistically different . For the r-PA group , the rate of re-open are separately 34.29% (30min) , 62.86% (60min) ,85.71% (120min) . For the UK group , the rate of re-open are separately 14.29% (30min) , 30.95% (60min) , 57.75% (120min) . The rate of re-open is higher in r-PA group than in UK group during every time period . The two groups were significantly statistically different . The rate of re-open during 30min and 60min in r-PA group are both higher that during 60min and 120min in UK group . The rate of re-open in r-PA group is ahead of that in UK...