The Clinical Study of Human Tissue Urokinase Plasminogen Activator in Patients with Acute Myocardial Infarction

Objective: To observe the the intravenous Chinese human tissue urokinase-type plasminogen activator (HTUPA, special Lipu enzyme) thrombolytic therapy for acute ST-segment elevation myocardial infarction security, validity. : ST-segment elevation myocardial infarction patients will be selected into divided into two groups according to the random number table, its the given HTUPA (Rite ordinary enzyme) / rt-PA thrombolytic therapy (Ai Tong Li) by clinical symptoms, the crown The Angiography and laboratory evaluation Bentley thrombolysis safety and efficacy of the treatment of acute ST-segment elevation myocardial infarction. Results: This test is based on Ⅰ, Ⅱ a clinical trial to obtain satisfactory results of the conducted Ⅱ b stage clinical trials a total selection of patients 40 Li (selected from Liaoning Province People's Hospital) which the special force general enzyme (HTUPA) group 19 Li, love pass legislation (rt-PA) group of 21 patients. No significant difference between the two groups of the general clinical data: (1) coronary angiography to determine recanalization rate of confirmed special the Lipu enzyme (HTUPA) group coronary recanalization in 16 patients, 19 patients coronary angiography Tip TIMI Ⅲ 11 cases, TIMI Ⅱ level in five cases, three cases of TIMI1 or 0 patients, coronary recanalization rate of 76.2%; coronary recanalization in 17 cases of 21 patients in the rt-PA group, coronary angiography prompted TIMI3 13 cases of grade, TIMI2 grade 4 cases, TIMI1-level or TIMI0 of 4 cases, recanalization rate of 89.5%, rt-PA group recanalization rate slightly higher than the special the Lipu enzyme (HTUPA) group, but not statistically significant, that the recanalization was no significant difference; adverse events (2) between the two groups within 30 days of cardiac rupture, malignant arrhythmia, acute heart failure, reinfarction, and death during hospitalization between the two groups was not significant difference in the incidence, no significant . Is special the Lipu enzyme (HTUPA) group within 30 days of severe arrhythmia 4 people 2 passengers, acute left ventricular failure, acute reinfarction people, 2 people allergic rash Total complication 9 people; serious rt-PA group arrhythmia 6 people, acute left ventricular failure and four passengers, heart rupture passengers, allergic rash person cardiopulmonary resuscitation by a person, people died during hospitalization, a total of 14 people complications, both in serious arrhythmia, acute left ventricular failure and other complications and total complications visitors have advantages and disadvantages, but statistically no difference; (3) special the Lipu enzyme (HTUPA) after thrombolysis group 2 passengers sputum in the blood, a person urinary system bleeding (microscopic hematuria), bleeding Total 3 passengers were mild bleeding improved after giving symptomatic disposal; rt-PA group after thrombolysis passengers puncture of the skin and mucous membrane bleeding ( site bleeding), 4 people bloody sputum people intracranial hemorrhage (head CT proved to be less than 10 ml brain hemorrhage), 1 person urinary tract bleeding (microscopic hematuria), bleeding total of 7 people were mild bleeding, after corresponding treatment improved between the two groups by the χ ~ 2 test confirmed that the difference was not statistically significant. Conclusion: 1. Special Lipu enzyme intravenous thrombolytic therapy for acute myocardial infarction with ST-segment elevation intravenous thrombolysis with rt-PA treatment of ST-segment elevation acute myocardial infarction, and quite effective in the treatment of coronary recanalization rate. 2 special Lipu enzyme intravenous thrombolytic therapy for ST-segment elevation acute myocardial infarction compared with intravenous rt-PA thrombolytic therapy, the results confirmed that the special the Lipu enzyme intravenous thrombolytic therapy did not increase the malignant arrhythmia, acute heart failure, reinfarction no effect on the incidence of serious complications such as liver and kidney function, therefore prompt safer, but the small number of experimental samples, and look forward to further expand the sample size and validation. 3 special Lipu enzyme intravenous thrombolytic therapy ST segment elevation acute myocardial infarction compared with rt-PA intravenous thrombolytic therapy, the dose is small, the time is short, no need to point static and repeated administration for acute myocardial infarction The treatment has won valuable time, is more suitable for clinical applications.