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Effects of intravenous thrombolysis for acute myocardial infarction on platelet activation and vascular function
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- Author:
- No author available
- Journal Title:
- JOURNAL OF EMERGENCY MEDICINE
- Issue:
- 3
- DOI:
- 10.3760/j.issn:1671-0282.2002.03.006
- Key Word:
- 链激酶;尿激酶;急性心肌梗死;溶栓疗法
Abstract： 目的急性心肌梗死(AMI)是心血管急症这一,链激酶(SK)、尿激酶(UK)同属第一代溶栓剂,在我国AMI临床治疗中应用广泛.本研究的目的在于比较SK与UK静脉溶栓对血小板、内皮细胞功能、肾素活性的影响及其临床意义.方法选择符合1979年WHO诊断标准的AMI患者45例,其中16例使用SK治疗(SK组),14例使用UK溶栓治疗(UK组),15例接受常规治疗作为对照组.所有患者于入院即刻及发病后24h、第7天分别采卧位静脉血5ml,测定血栓素B2(TXB2)、6-酮-前列腺素Fla(6-keto-PGFla)、血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)的水平.结果 TXB2在SK组治疗前后及对照组各点均有升高,二者比较,差异无显著意义,UK组治疗后(即发病后24h、7thd)较对照组、SK组明显升高;6-keto-PGFla在3组无变化;二者比值TXB2/6-keto-PGFla(T/P)在UK组也明显升高;PRA、AngⅡ在3组呈升高趋势,但差异无显著意义.结论心梗后及SK、UK溶栓后血小板活性均有增强,UK和SK相比,前者使血小板活化作用更强.这种作用可能会限制溶栓的效果,故溶栓治疗中尤其UK溶栓时更应加强抗血小板治疗,包括加大阿司匹林剂量或加用其他更有效的抗血小板制剂.
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