【摘要】 目的:通过与重组组织型纤溶酶原激活剂(rt-PA)对比,观察重组葡激酶(r-SAK)对急性心肌梗塞(AMI)患者溶栓治疗前后血浆中血小板α-颗粒膜蛋白(GMP-140)、凝血酶-抗凝血酶复合物(TAT)含量的影响,评价其对AMI对凝血系统的影响和对血小板活化的作用。方法:选择确诊为AMI发病12 h以内患者33例,随机分为r-SAK治疗组(n=17)和rt-PA对照组(n=16),测定两组溶栓治疗前、溶栓后2 h血浆中GMP-140、TAT含量及溶栓90 min后冠脉造影等相关指标。结果:两组溶栓治疗后血浆中GMP-140含量均高于治疗前(P<0.05);与r-SAK组溶栓治疗后比较,rt-PA组溶栓治疗后血浆中GMP-140含量显著升高(P<0.05),r-SAK组溶栓治疗后2 h血浆中TAT浓度略有升高(P>0.05),rt-PA组溶栓治疗后2 h血浆中TAT浓度显著升高(P<0.05)。两组溶栓治疗后再灌注率无明显差异。结论:AMI患者应用r-SAK与rt-PA溶栓治疗有同等的溶栓疗效,r-SAK较rt-PA有更强的血栓选择性,促凝活性微弱,促血小板活化低,减轻血栓前状态对心肌损伤作用,可以改善心肌微灌注。更多还原

【Abstract】 Objective To observe the effects of recombinant staphylokinase (r-SAK) on platelet activation parameters in patients with acute myocardial infarction(AMI) by intravenous thrombolysis in order to investigate the clinical thrombolytic efficacy of r-SAK therapy in AMI comparing with recombinant tissue-type plasminogen activator(rt-PA) therapy.Methods Thirty-three patients with AMI within 12 h after the onset were selected and divided randomly into the r-SAK therapy group(n=17) and rt-PA therapy group(n=16).Coronary artery angiography(CAG) was performed 90 min after thrombolytic therapy in patients.Thrombin-antithrombin complex(TAT) and alpha granule membrane protein(GMP-140) were measured by similar commercial enzyme-linked immunosorbent assay(ELISA).Results In r-SAK group and rt-PA group,the plasma contents of GMP-140 2 h after thrombolytic therapy were significantly higher than before therapy(P<0.05).There was statistically significant difference of the plasma contents of GMP-1402 h after thrombolytic therapy between two groups(P<0.05).In(r-SAK) group,the plasma content of TAT 2 h after thrombolytic therapy increased slightly(P>0.05).In rt-PA group,the plasma content of TAT 2 h after thrombolytic therapy increased significantly(P<0.05).There was no statistically significant difference of the reperfusion rate at 2 h after thrombolytic therapy between two groups((P>0.05).) Conclusion r-SAK has similar effect with rt-PA and it will become available for highly fibrin-selective thrombolytic therapy of AMI.Thrombolytic treatment with r-SAK can improve the injury of myocardial microperfusion.更多还原