【摘要】 用重组组织型纤溶酶原激活剂（ＲｅｃｏｍｂｉｎａｎｔＴｉｓｓｕｅＴｙｐｅＰｌａｓｍｉｎｏｇｅｎＡｃｔｉｖａｔｏｒ，ｒｔ－ＰＡ）改良方案（ｒｔ－ＰＡ１０ｍｇ在两分钟内静注，接住在４５分钟内以０．８８ｍｇ／ｍｉｎ速率滴注４０ｍｇ，滴完前５分钟作心电图，心肌酶检查，判定心肌再灌注，若心肌未获再灌注，冠脉未再通，则继续给予ｒｔ－ＰＡ以同样速率０．８８ｍｇ／ｍｉｎ滴注５０ｍｇ总剂量不超过１００ｍｇ，根据非介入性临床指标判断，心肌再灌注率９１．４％，未见严重出血并发症及住院期冠脉再堵塞，２３例ｒｔ－ＰＡ用量５０ｍｇ及９例用量１００ｍｇ获心肌再灌注，结果显示：改良方案可提高心肌再灌注率及降低费用，并且不增加出血并发症及住院期内冠脉再堵塞。更多还原

【Abstract】 Abstract:35 cases with acute myocardial infarct were treateed by rt - PA thrombolytic therapy according a modified protocol(10 mg iv, 40mg in 45 min, if reperfusion achieved, stop infusion. othdrise additive 50 mg in 50 minutes). Based on the assessment by bedside markers of reperfusion, the results showed myocardial reperfusion rate was 91. 4% and no major bleeding complication and reocclusion was reported. Of 32 cases with reperfusion achieved in this modified protocol study, 23 patients with total dose of 50 mg and 9 patients with total dose of 100 mg achieved reperfusion. This clinical study showed that the "come Through, Then Stop" modified protocol may increase the reperfusion rate and reduce treatment cost. while a low bleeding complication and reocclusion rate were maintained.更多还原