Clinical Observation of Urokinase and Alteplase Each Combined with Enoxaparin Sodium in the Treat-ment of Acute ST Segment Elevation Myocardial Infarction / 中国药房

ABSTRACT

OBJECTIVE:To compare clinical efficacy,safety and economy of urokinase and alteplase each combined with Enoxaparin sodium in the treatment of acute ST segment elevation myocardial infarction (STEMI). METHODS:80 STEMI pa-tients were randomly divided into control group and observation group,with 40 cases in each group. Both groups received Aspirin enteric-coated tablet for antiplatelet aggregation,and Clopidogrel hydrogen sulfate tablet for anticoagulation before thrombolysis. Control group were given urokinase 1 500 000 U added into 0.9% Sodium chloride injection 100 ml,ivgtt,within 30 min;given Enoxaparin sodium injection 7 500 U intramuscularly 12 h after thrombolysis,for 3-5 d. Observation group was given Enoxaparin sodium 60 U/kg,ivgtt,1 mg/ml Alteplase for injection 8 ml with intravenous push,other 42 ml ivgtt within 90 min;continued to receive Enoxaparin sodium with 12 U/(kg·h)micro-pump for 48 h,followed by Low molecular weight heparin calcium injection 5 000 U intramuscularly,bid,for consecutive 5 d. Clinical efficacy of 2 groups were observed,and thrombolytic recanalization situa-tion were observed 30,60,90 and 120 min after thrombolysis. ECG,cost-effectiveness and ADR were also observed. RESULTS:The effective rate of observation group(92.50%)was significantly higher than that of control group(85.00%). The rates of throm-bolytic recanalization in observation group 60,90 and 120 min after thrombolysis were significantly higher than in control group, with statistical significance(P0.05). The incidence of ventricular aneu-rysm,pericardial effusion,heart failure or cardiac shock,angina pectoris after infarction,severe arrhythmia,death and other as-pects in observation group were significantly lower than in control group,with statistical significance(P<0.05). CONCLUSIONS:Alteplase and enoxaparin thrombolysis therapy is better than urokinase and enoxaparin for STMEI in respects of clinical efficacy, and thrombolytic recanalization with less ADR and better safety;urokinase is cheaper and better than alteplase in cost-effectiveness ratio. Both of them can be used after careful consideration.