目的:探讨尿激酶与重组人组织型纤溶酶原激活物(rt-PA)溶栓治疗对 ST 段抬高型心肌梗死(S T EM I)患者心肌损伤程度影响的差异.方法:收集2016年8月~2017年8月间在本院接受溶栓治疗的STEMI患者130例,回顾治疗方案,并将入组患者分为尿激酶溶栓组68例,rt-PA 溶栓组62例.对比两组患者接受不同溶栓治疗前后血清中心肌损伤标志物、炎症介质、氧化应激指标含量的差异.结果:溶栓前,两组患者血清中心肌损伤标志物、炎症介质、氧化应激指标含量的差异无统计学意义(P>0.05).溶栓后1周,rt-PA溶栓组血清中心肌损伤标志物NT-proBNP、MYO、cTNⅠ、H-FABP的含量较尿激酶溶栓组低(P<0.05);血清中炎症介质IL-6、IL-23、hs-CRP的含量较尿激酶溶栓组低(P<0. 05);血清中氧化应激指标GSH-Px、T-AOC的含量较尿激酶溶栓组高(P<0.05),MDA、LHP的含量较尿激酶溶栓组低(P<0.05).结论:STEMI患者接受rt-PA 溶栓治疗,在早期减轻心肌损伤程度方面的作用优于尿激酶溶栓.%Objective:To investigate the different effects of urokinase and rt-PA thrombolysis on myocardial injury in patients with STEMI.Methods:130 patients with STEMI who accepted thrombolysis in the hospital between August 2016 and August 2017 were reviewed and divided into urokinase thrombolysis group(n=68)and rt-PA thrombolysis group(n=62). The differences in serum levels of myocardial injury markers,inflammatory mediators and oxidative stress indexes were com-pared between the two groups of patients before and after different thrombolysis treatments.Results:Before thrombolysis, there was no statistically significant difference in serum levels of myocardial injury markers,inflammatory mediators and oxida-tive stress indexes between the two groups.1 week after thrombolysis,serum myocardial injury markers NT-proBNP,MYO, cTNⅠ and H-FABP levels of rt-PA thrombolysis group were lower than those of urokinase thrombolysis group;serum inflam-matory mediators IL-6,IL-23 and hs-CRP levels were lower than those of urokinase thrombolysis group;serum oxidative stress indexes GSH-Px and T-AOC levels were higher than those of urokinase thrombolysis group whereas MDA and LHP lev-els were lower than those of urekinase thrombolysis group.Conclusion:rt-PA thrombolysis is better than urokinase thromboly-sis in reducing the early myocardial injury in patients with STEMI.
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