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OBJECTIVE： To evaluate therapeutic efficacy of reteplase versus alteplase in the treatment of acute myocardial infarction in China， and to provide evidence-based reference for clinical treatment. METHODS： Retrieved from Cochrane library， PubMed， Embase， Medline， CJFD， CSJD， Wanfang database by computor， etc.， also by manual search， RCTs about therapeutic efficacy （recanalization rate of thrombolysis） of reteplase （trial group） versus alteplase （control group） in the treatment of acute myocardial infarction in China were collected from Jan. 1995 to Sept. 2018. After data extraction and quality evaluation with Cochrane system evaluator manual 5.1.0， Meta-analysis was performed for recanalization rate of thrombolysis by using Rev Man 5.3 software. RESULTS： A total of 23 RCTs were included， involving 1 742 patients. Results of Meta-analysis showed that recanalization rate of thrombolysis in trial group was significantly higher than control group， with statistical significance [OR＝0.61，95％CI（0.50，0.73），P＜0.001]. Sub-group Meta-analysis was performed according to the successful time of thrombolysis. Results of Meta-analysis showed that recanalization rate of thrombolysis in trial group 1 h [OR＝0.38，95％CI（0.25，0.58），P＜0.001]， 1.5 h [OR＝0.44，95％CI（0.25，0.79），P＝0.006] and 2 h [OR＝0.62，95％CI（0.42，0.92），P＝0.02] after thrombolysis were significantly higher than control group， with statistical significance. CONCLUSIONS： The recanalization rate of thrombolysis by reteplase in Chinese patients with acute myocardial infarction in better than by alteplase.
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To study influence of ticagrelor combined reteplase (rPA) intravenous thrombolysis on serum levels of ryanodine receptor 2 (RyR2) and uncoupling protein 2 (UCP2) and cardiac function in aged patients with acute ST elevation myocardial infarction (STEMI ).Methods :A total of 92 STEMI patients treated in our hospital from Dec 2015 to Dec 2017 were selected .Patients were divided into ticagrelor group (n＝47) and clopidogrel group (n＝45) according to therapeutic method ,both groups received corresponding medication based on aspirin ,rPA and routine treatment for three months .Coronary recanalization rate on 30～120min after treatment ,serum levels of RyR2 ,UCP2 and cardiac function indexes before and after treatment ,adverse reaction were observed and compared between two groups .Results :As time went on ,coronary recanalization rate gradually rose in two groups , P＜0. 05 or ＜0. 01 ,but there was no significant difference between two groups , P＞ 0. 05 all.Compared with clopidogrel group after treatment ,there were significant rise in serum levels of RyR 2 [ (0.44 ± 0.08) μg／ml vs .(0. 48 ± 0. 09) μg／ml] ,UCP2 [(0. 40 ± 0. 09) μg／ml vs.(0. 45 ± 0. 08) μg／ml] ,LVEF [(58.56 ± 4. 05)% vs.(61. 95 ± 4. 63)%] and mitral early／late diastolic peak flow velocity [E／A ,(1.19 ± 0. 22) vs.(1.30 ± 0. 24)] ,and significant reduc‐tions in LVESd [(51.95 ± 8.64) mm vs.(47.32 ± 6.49) mm] ,LVEDd [(62.36 ± 9.71) mm vs.(56.72 ± 10. 43) mm] ,incidence rate of cardiovascular events (22.22% vs.6. 38%) ,mean hospital stay [ (5.63 ± 1.04) d vs.(4. 92 ± 0.87) d] and incidence rate of hemorrhage (28.89% vs .10. 64%) in ticagrelor group , P＜0.05 or ＜0.01. Con‐clusion :Ticagrelor combined rPA intravenous thrombolysis possesses high coronary recanalization rate in aged STE‐MI patients .It can significantly improve cardiac function and reduce incidence of cardiovascular events and hemor‐rhage .
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Objective@#To assess the efficacy and safety of thrombolytic treatment with reteplase in patients with intermediate-risk acute pulmonary embolism.@*Methods@#Ten consecutive patients with intermediate-risk acute pulmonary embolism who received thrombolytic treatment with reteplase at Thrombosis and Vascular Medicine Center, Fuwai Hospital from March to November in 2016 were included.Vital signs, right ventricular diameter, systolic pulmonary artery pressure, and biochemical markers were assessed before and after thrombolytic therapy with reteplase, and bleeding complications were also observed during 3 months follow up.@*Results@#(1) For the efficacy outcomes: at 48 hours after thrombolytic treatment with reteplase, echocardiography-derived diameter of right ventricular was significant reduced from (27.9±3.8) mm to (24.8±2.6) mm (P=0.03), systolic pulmonary artery pressure decreased from (63.9±21.6) mmHg(1 mmHg=0.133 kPa) to (34.4±19.8) mmHg (P=0.02). Heart rate and breathing rate were also decreased significantly (both P<0.05), blood pressure remained unchanged post therapy.Hypoxemia was quickly corrected with an significant elevation of PaO2 and SaO2 ((65.2±14.3) mmHg vs. (80.0±9.6) mmHg, P=0.006; (90.8±3.5)% vs. (95.2 ±1.6)%, P=0.002 respectively). PaCO2 was also increased significantly (P<0.05). Serum NT-proBNP and cTnI were decreased significantly (both P<0.05). There was no recurrent pulmonary embolism or deep-vein thrombosis during the 3 months follow-up. (2) For the safety outcomes: a thrombolytic relevant hemoptysis (about 70 ml) occurred in 1 patient, and was controlled by PCC therapy.No other clinically relevant events were observed during thrombolytic treatment. Eight patients were followed more than 3 months, there was no major bleeding complication or death during the follow up period.@*Conclusion@#Treatment of intermediate-risk acute pulmonary embolism with reteplase is effective and safe and there are no obvious side effects.
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Objective To research the effect and safety of Reteplase for Injection combined with reduced glutathione in the treatment of acute ST segment elevation myocardial infarction.Methods Patients with acute ST segment elevation myocardial infarction (90 cases) in Jianli People's Hospital from February 2015 to February 2016 were selected and divided equally into A,B and C groups according to different treatment methods.Totally 30 patients in group A were given conventional therapy,30 patients in group B were given reduced glutathione for treatment on the basis of conventional treatment,and the other 30 in group C were given combined therapy of reteplase and reduced glutathione on the basis of conventional treatment.The vascular recanalization rate,improvement of effective indicators including creatine kinase isoenzyme (CKMB),troponin Ⅰ (cTnⅠ),left ventricular end diastolic diameter (LVEDd) and left ventricular ejection fraction (LVEF),oxidative stress kinase including superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px),and incidence of adverse events of patients were compared among the three groups.Results After thrombolysis,the vascular recanalization rate of group C at different time points (2 h,6 h and 12 h) showed significant difference compared with those of groups A and B (P ＜ 0.05).After the treatment,the effective indicators of the three groups were both significantly improved (P ＜ 0.05),and group C improved more significantly than groups A and B (P ＜ 0.05).After the treatment,the SOD and GSH-Px of groups B and C both significantly improved than group A (P ＜ 0.05),but there was no significant difference between groups B and C.After treatment,the incidence of adverse events of group C was significantly lower than those of groups A and B (P ＜ 0.05).Conclusion Reteplase for Injection combined with reduced glutathione has significant curative effect in the treatment of acute ST segment elevation myocardial infarction,which can effectively improve the cardiac function and inhibition of oxidative stress.It is of higher security but with lower incidence of adverse events.
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Moyamoya disease is a chronic progressive cerebrovascular disease. It got its nickname, the moyamoya disease, because the image of abnormal blood vascular net at the skull base in the encephaloangiography of such patients is very similar to smog. The moyamoya disease can be divided into two types: ischemic and hemorrhagic according to its clinical manifestations and imaging characteristics. In the ischemic type of moyamoya disease, when the blood vascular lumens are not narrow enough to completely block the blood flow, the chief manifestation is the cerebral blood circulation insufficiency; when the salvage is not in time, the disease will further progress to develop vascular obstruction or thrombosis, resulting in cerebral infarction, finally hemiplegia, aphasia, etc. irreversible symptoms and signs occur. In the primary hospital, the first choice for treatment of acute cerebral infarction (ACI) is drug thrombolysis. However, the main treatment for moyamoya disease with ACI is chiefly revascularization. This article reported a patient with moyamoya disease and ACI successfully treated by intravenous reteplase for thrombolysis in People's Hospital of Pucheng County.
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Objective To compare the therapeutic efficacy of reteplase(r-PA) and alteplase(t-PA) in the high risk patients with pulmonary embolism during a pulmonary artery catheter broken bolt in the interventional treatment,and to evaluate the clinical safety.Methods 54 high risk patients were selected as the research subjects,and they were randomly divided into treatment group(24 patients) and control group(30 patients).Patients in both two groups were given general treatment,low molecular heparin sodium anticoagulation therapy.Besides,the control group was given local perfusion thrombolysis enzyme treatment.While the treatment group was given local perfusion at enzyme thrombolysis treatment.Results Two-way Chi-square test results showed that before treatment,there were no significant differences in HR,RF,PaO2,PaCO2 and SaO2 between the two groups(all P>0.05).After 3-day treatment,in the treatment group,HR[(83.39±14.25)times/min],RF[(17.80±1.65)times/min],PaO2[(87.59±7.34)mmHg],PaCO2[(37.60±7.62)mmHg],SaO2[(97.29±6.72)%] in the treatment group group,which in the control group were (97.7±15.51)times/min,(20.49±1.68)times/min,(81.53±6.42)mmHg,(35.69±4.57)mmHg,(93.91±3.27)%,the differences between the two groups were statistically significant(t=8.01,7.33,6.32,all P<0.05).After three days therapy,the total effective rate was 86.67% in the treatment group,which was significantly higher than 75.00% in the control group (x2=1.21,P=0.55).After thrombolysis treatment,there was no significant difference between the treatment group and control group in hemorrhage rate(x2=2.24,P=0.53),which were 13.33% and 12.50%,respectively.Besides,the hemorrhage patients were all got effectively treated and their condition was significantly improved,and none of them occurred severe bleeding during the observation periods in the two groups.Conclusion Local perfusion reteplase therapy in high-risk patients with PE through the pulmonary artery catheter broken bolt in the interventional treatment is safe and is worthy of clinical promotion.
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Objective To investigate the effect of the combination therapy of tirofiban and reteplase on endothelial function,coagulation function and plaque inflammation in elderly patients with ST-elevation acute myocardial infarction (STEMI).Methods 100 patients with STEMI were treated with percutaneous transluminal coronary intervention (PCI) from January 2014 to June 2016 in our hospital.39 cases in the control group used conventional oral aspirin,clopidogrel and statins and other treatment.61 cases in the observation group received tirofiban and reteplase on the basis of the control group.The expression of endothelial microparticles (EMP) was detected by flow cytometry (FCM),and the ICAM-1,high sensitivity C-reactive protein (hs-CRP),tumor necrosis factor α(TNF-α) and interleukin-6 (IL-6),endothelin-1(ET-1) were measured by enzyme-linked immunosorbent assay (ELISA).The thrombin time (TT),activated partial thrombin time (APTT),prothrombin time (PT) and other indicators were measured by PUN-2048A coagulation instrument,then statistical analysis was performed.Results The postoperative levels of EMP,ICAM-1 and ET-1 of control group were (693.46±90.72),(768.58±20.46)μg/L and (31.27±8.18)ng/L,which were significantly higher than those in the observation group [(652.36±67.39),(752.37±25.0)μg/L,(28.22±5.05)ng/L],the differences were statistically significant (t=2.41,2.67,2.68,all P<0.05).After operation,the hs-CRP,TNF-α,IL-6 levels in the control group were (4.16±2.35)mg/L,(4.32±2.02)ng/L,(10.59±3.16)ng/mL,which were significantly higher than those in the observation group [(2.22±1.47)mg/L,(2.74±1.52)ng/L,(6.33±2.24)ng/mL],the differences were statistically significant(t=2.65,2.67,3.42,all P<0.05).The postoperative TT,PT,APTT in the observation group were (26.31±3.18)s,(14.34±1.67)s,(27.20±4.12)s,which were significantly longer than those in the control group [(24.03±2.84)s,(12.56±1.43)s,(24.55±3.62)s],the differences were statistically significant(t=2.15,2.31,2.65,all P<0.05).Conclusion Tirofiban combined with reteplase can improve endothelial function,inhibit inflammatory reaction and regulate coagulation function.
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Objective To compare the efficacy and safety of prourokinase,reteplase and urokinase on the patients with acute ST -segment elvation myocardial infarction.Methods According to random number table,the eligible patients with acute ST -segment elvation myocardial infarction were randomly divided into prourokinase group (50mg,n =34),reteplase group (36mg,n =42)and urokinase group (1 500 000IU,n =32).The patency of infarct related coronary artery was estimated by coronary angiography at 90min after administration of thrombolytic agents.The adverse reaction was also observed including bleeding and the major adverse cardiac events(MACEs).Results The patency of culprit vessel in the prourokinase group was 76.50% (≥TIMI 2 flow),which in the reteplase group was 83.30% (≥TIMI 2 flow),and which in the urokinase group was 53.10% (≥TIMI 2 flow),respctively.Both of prourokinase group and reteplase group were higher in the patency than theurokinase group(χ2 =8.27,P =0.004). The MACEs and bleeding adverse reaction(prourokinase group 17.65%,reteplase group 28.57%,urokinase group 42.19%)showed that security of prourokinase group was securer than reteplase group and urokinase group(χ2 =6.36,P =0.012).Conclusion Both of prourokinase and reteplase are effective for the patients with acute myocardial infarction with ST -segment elvation,and prourokinase is safer.
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Objective To explore the curative effect of reteplase and urokinase in treatment of acute ST elevation myocardial infarction.Methods 116 patients with acute ST segment elevation myocardial infarction who were diagnosed and received treatment in our hospital from October 2013 to October 2015,were selected as the study subjects and were randomly divided into two groups with 58 cases in each group according to the single blind method. The control group was treated with urokinase thrombolytic therapy,while the patients in the observation group were treated with reteplase thrombolytic therapy.The thrombolytic recanalization rate,and adverse event incidence were compared in the two groups.Results The clinical judgement thrombosis recanalization rates in the observation group after 0.5h,1h,1.5h,2h of thrombolysis were 27.59%,60.34%,81.03% and 86.21% respectively,which were sig-nificantly higher than 15.52%,29.31%,62.07%,70.69% of the control group,the differences between the two groups were statistically significant(χ2 =3.853,3.907,3.898,3.524,all P 0.05).Conclusion Reteplase for acute ST segment elevation myocardial infarction thrombo-lytic therapy is better than urokinase,has a high patency rate and low incidence of adverse events,it is safe and worthy of clinical popularization and application.
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Objective To observe the effect of reteplase on the thromboelastogram tracing of patients experiencing acute is-chemic stroke(AIS).Methods Selected 43 AIS inpatients in the Third People’s Hospital of Liaocheng from October,2013 to August,2015,who received reteplase less than 4.5 hours after the onset of syndrome of AIS.Blood samples were obtained before reteplase administration and at 0.5,1,2 and 4 hours after reteplase administration and measured by thromboelastogra-phy.Results The parameters R,K,Angle and MA of the thromboelastogram had changed after beginning administration of reteplase.The R value at 0.5 h after thrombolysis was significantly higher than that before thrombliysis,however,the R Value at 1h after thrombolysis was the most highest,and the K value.At 0.5 h after thrombolysis was the highest.At 0.5 h after thrombolysis MA and Angle values were the lowest,the differences were statistically significant (P<0.001).Conclu-sion The study suggests that the thromboelastogram is an useful tool for determining changes in the coagulation system of patients receiving reteplase.
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Objective:To observe the therapeutic effect and timing of reteplase in patients with ST-segment elevation myocardial infarction (STEMI) .Methods:A total of 106 STEMI patients were selected from Central Hospital of Wafangdian City of Liaoning Province , from Jan 2013 to Apr 2014 ,and all patients received thrombolytic treat-ment .According to the duration from onset to thrombolysis ,patients were divided into :group 1 with duration 0.05 all) .Conclusion:The thrombolytic recanalization rate is highest ,and the 30d all-cause mortality and incidence rate of adverse reactions are lowest for thrombolysis within 3 h from onset .
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Objective To investigate the clinical efficacy and safety of reteplase(rPA)adminis-tration in treating acute deep venous thrombosis(ADVT)of lower extremity.Methods A total of 1 87 pa-tients with ADVT were randomly divided into two groups,with 85 patients in rapid intravenous dripping group and 1 02 patients in 24-hour venouspumping group.Their effects on limb swelling,thrombolysis,and complicationswere compared for analysis.Results The differences in the curative effectsof reducingswell-ingand thrombolysis effect between the two groups werenot significant(P >0.05).Thethrombolysis time in the 24-hour venouspumping group was shorter than that of the rapid intravenous dripping group [(4.76 ± 1 .56)days vs(6.56 ±0.83)days,P <0.05],indicating 24-hour venouspumping was more effective than rapid intravenous dripping.Complication incidence in the 24-hour venouspumping group was less than that of the rapid intravenous dripping group(3.90% vs 1 7.6%,P <0.05).Conclusion rPA is a goodvenous thrombolytic agentwith rapid effect in treating ADVT.The 24-hour venouspumping was more effective and safe than the rapid intravenous dripping.
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Objective To investigate the treatment of the lower extremity deep venous thrombosis .Methods Sixty patients with lower extremity deep venous thrombosis were analyzed retrospectively .Thirty two patients underwent reteplase thrombosis ,and 28 patients underwent recombinant streptokinase thrombosis ;the effects of each group were compared;and the various complications and adverse events were observed .Results Patients in two groups were all effectively treated ,and the effective rate of reteplase group was higher than recombinant streptokinase group (P0 .05) .During the follow‐up ,there was no reoccurrence in all 60 patients .Conclusion Reteplase thrombolytic therapy for the lower extremity deep venous thrombosis is safe and effective .
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Objective To observe and analyze the curative effects and safety of reteplase ( rPA) combined with reduced glutathione ( GSH) in the treatment of acute ST segment elevation myocardial infarction.Methods 86 cases of patients with acute ST elevation myocardial infarction in our hospital from April 2013 to April 2014 were ran-domly selected, and divided equally into two groups according to different treatment methods.43 patients in the control group were merely given reteplase for treatment, whereas the other 43 in the experiment group were given com-bined therapy of reteplase and reduced glutathione.The vascular recanalization rate, improvement of effective indicators and incidence of adverse events of patients were compared between the two groups.Results After thrombolysis, the vascular recanalization rate of the experiment group in different time points (2h, 4h and 6 h after thrombolysis) showed no significant difference compared with that of the control group (p>0.05).After the treatment, the effective indicators of the two groups both significantly improved, and the experiment group improved more significantly than the control group (p<0.05, p<0.01).The incidence of adverse events of the experiment group was significantly lower than that of the control group (p<0.05).Conclusion Reteplase combined with reduced glutathione is of sig-nificant curative effect in the treatment of STEMI, which can effectively improve the cardiac function.It is of higher security but with lower incidence of adverse events.
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Objective To study the thrombolysis effect and safety of tirofiban combined with half dose reteplase in patients with ST segment elevation acute myocardial infarction .Methods 60 patients with ST segment elevation acute myocardial infarction in our hospital from January 2011 to March 2013 were selected as research object ,and they were divided into reteplase group (control group ,n=32) and tirofiban combined with reteplase group (observation group ,n=28) ,then the recanalization rate of infarct-relat-ed artery at different time and incidence of complications were compared .Results The recanalization rate of infarct-related artery of observation group at different time were all higher than those of control group (P0 .05) .Conclusion The thrombolysis effect of tirofiban combined with half dose reteplase in patients with ST segment elevation acute myocardial infarction is better ,and it does not increase the incidence of complications .
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Objective To evaluate the clinical effect and safety of transcatheter thrombus-breaking combined with local infusion of reteplase (rPA) in treating severe pulmonary thromboembolism (PTE). Methods During the period from June 2010 to June 2013 at authors’ hospital, transcatheter thrombus-breaking combined with local infusion of reteplase was carried out in 26 patients (17 males and 9 females) with severe pulmonary embolism. The changes of pulmonary circulation and the cardio - pulmonary hemodynamics after the treatment were analyzed. Results The preoperative mean pulmonary artery pressure, arterial blood oxygen partial pressure and the blood pressure were (63.78 ± 6.89) mmHg, (73.23 ± 11.51) mmHg and (87.35 ± 10.92) mmHg respectively, while the postoperative ones were (26.23 ± 10.27) mmHg, (93.48 ± 6.17) mmHg and(127.14 ± 13.15) mmHg respectively, and the differences between preoperative and postoperative ones were statistically significant (P<0.01). All the patients were followed up for 6 - 36 months. Significant stable clinical improvement was obtained in 25 patients, and recurrence was seen in one patient. Conclusion Transcatheter thrombus-breaking combined with local infusion of reteplase can quickly improve the pulmonary circulation and the clinical conditions for patients with severe pulmonary thromboembolism, and it has no obvious complications. This technique carries excellent value in maintaining the stability of hemodynamics.
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Objective To construct the prokaryotic expression system of reteplase fusion protein and research the effect of chaperones on its renaturation. Methods Inserted the reteplase gene into the prokaryotie expression vector PET32a and then expressed it by the induction of IPTG in E. coli BL21. Researched the effect of chaperones on the renaturation of fusion protein by adding different chaperones. Results The analysis of SDS-PAGE and Western blot indicated that reteplase fusion protein was expressed correctly. Chaperones DsbA,pKJE7,pTf16 had the conspicu-ous effect on the renaturation of fusion protein. The result of activity assay indicated that the refolded reteplase fu-sion protein had fibrinolytic activity. Conclusion Chaperones can promote renaturation of reteplase fusion protein.
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Reteplase is a third-generation recombinant form of t- PA (tissue plasminogen activator). A phase–III prospective, multi-centric trial and retrospective, post-marketing surveillance (PMS) of reteplase have been conducted to evaluate the efficacy and safety of reteplase in patients with ST segment Elevation Myocardial Infarction (STEMI). Phase-III trial was a prospective, multi-centric, open-label study conducted across 15 centers in India. 80 patients out of 83 screened were enrolled in the study. Patients with STEMI admitted to an intensive care unit in a hospital within 6 hours of onset of symptoms and meeting all eligibility criteria were enrolled in the study. Each patient received a total dose of 20 units of reteplase. The dose was given as two 10 unit intravenous injections each over two minutes, no more than 30 minutes apart. The primary objective of the study was to evaluate the all cause mortality rate at 30 days post-dosing in patients with STEMI following treatment with reteplase. Safety assessment was based on treatment emergent adverse events, physical examinations, vital signs, ECGs, echocardiography and safety laboratory tests. A Post Marketing Surveillance (PMS) following the marketing approval in India was undertaken to assess the safety profile of reteplase in patients with STEMI and/or recent left bundle branch block. Reteplase was administered as two bolus injections of 10 units each. Each bolus was administered as a slow intravenous injection over 2 minutes. Total 204 patients’ data has been considered for the analysis in present post-marketing study. The results of both these studies are discussed. In both these studies, reteplase efficacy and safety were well established in treatment of patients with ST segment elevation Myocardial Infarction (STEMI).
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Adolescent , Adult , Aged , Arrhythmias, Cardiac/epidemiology , Electrocardiography , Female , Humans , India , Male , Middle Aged , Myocardial Infarction/drug therapy , Product Surveillance, Postmarketing , Recombinant Proteins/therapeutic use , Stroke/epidemiology , Tissue Plasminogen Activator/therapeutic use , Treatment Outcome , Young AdultABSTRACT
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.
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Objective To observe the effect of small dose reteplase thrombolytic therapy on old patients with acute myocardial infarction(AMI).Methods Eighty-two old patients with AMI were divided into two groups by random digits table,each group had 41 cases.Control group was treated with recombinant streptokinase,and observation group was treated with small dose reteplase.The clinical effect,1 h and 2 h coronary artery recanalization rates between two groups were compared.Results After treatment 24 h,there was no significant difference in total effective rate and death rate between two groups(P＞ 0.05).The 1 h and 2 h coronary artery recanalization rates in observation group were significantly higher than those in control group[56.1％(23/41)vs.26.8％(11/41),63.4％(26/41)vs.39.0％(16/41)](P＜ 0.05).The mild bleeding incidence in observation group was significantly higher than that in control group(P ＜ 0.05),while there was no significant difference between two groups in severe bleeding incidence(P ＞ 0.05).Conclusion Small dose reteplase thrombolytic therapy on old patients with AMI is effective,which provide a safe and effective method for elderly patients unwilling or unable to accept the coronary angioplasty.