What is the urokinase thrombolytic effect?New Analysis of Chinese Acute Histosis Registration Research

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What is the urokinase thrombolytic effect?New Analysis of Chinese Acute Histosis Registration Research

2021-11-25 14:48:08 14 ℃

At present, how is the safety and effectiveness of different thrombolytic drugs in my country's acute ST segment elevation myocardial infarction (Stemi)

At present, there are many kinds of drugs used in thrombolytic therapy, mainly divided into two categories: one is non-specific plasminogen activator, with urokinase as the main representation; the other is specific plasminogen The activator is mainly representative with atetase (RT-PA) and the resemble (R-PA).

A latest analysis of Chinese Acute Myocardial Infarction (CAMI) registration shows:

The overall myristor patients with a low thrombolytic, as compared with the urokinase, a higher clinical judged thrombolytic success ratio compared to urokinase, but the incident in the hospital is also more. .

Among the 18,381 STEMI patients selected from 2013 to 2014, 1793 cases (9.5%) received thrombolytic treatment.

A total of 1691 patients with urokinase, App enzymes, and resecking thrombolytic thrombolytic, 662 cases (39.1%) were treated with urokinase, 276 cases (16.3%) were treated with Appase, 753 cases (44.5 %) Accept reckility of the treatment.

Further analysis of patients who underwent these three drug thrombolytic thrombolytic have been found that patients with urokinase treatment have a clinical judgment of thrombolytic success rate of 69.2%, significantly lower than acceptance of Abget enzyme (83.0%) or Ruitutux (85.3) %), P <0.001, but its bleeding incident is also the lowest, and the three are 0.9%, 2.9%, 6.4%, P <0.001, respectively.

There were no significant differences in all done death, reproduction myocardial infarction, stroke, and lethal bleeding.

Regression analysis showed that the clinical judgmentary thrombolysis was successful, and the App enzyme (OR = 2.05) was superior to the urokinase.

In terms of bleeding incidents in the hospital, the Appase, the resembler is more risky.

For different times of thrombolysis on the pathogenesis, no matter whether the thornylase is about 3 h or> 3 h, urokinase clinical judgment thrombolytic success rate is the lowest.

my country's latest thrombolytic drug guide believes that urokinase vascular rehabilitation is lower than the specific plasminogen activator and the incidence of complications is high, so it is recommended that the primary hospital is preferred for specific plasminogen activator.

In this study, the three groups of urokinases, atepase, and the resecticulum thrombolytic thrombolytic thrombosis had different success rates, but during the hospitalization period, repeated death, then myocardial infarction, stroke There is no significant difference in the "hard end" event.

The researchers believe that the reasons may be:

(1) Clinical judgment thrombolysis and coronary arterial shadow judgment thrombolytic reunion, the former cannot fully reflect the coronary artery at the anatomical level;

(2) The survival benefits of higher thrombolytic rendering may be mainly reflected in long-term prognosis, and the ending of the hospital is not large.

China's adult acute ST segment elevated heart narrotypes have pointed out that my country's choice of thrombolytic drugs has risen to 56.6%, but it is still lower than in 2011 British Ruiticum. The third generation of thrombolytic drugs such as Neppase (71.3%).

The study also found that the proportion of patients with thorn thorn atomization of my country is only 27.9%, while in the same period (2014), 30 min, 30 min, 30 min, is as high as 54%, indicating the thrombolytic treatment of STEMI patients in my country. The front delay is still very serious.

The researchers said that they also need to promote the publicity of heart infarction in China, promote patients to see the treatment as soon as possible, and shorten the reperfusion treatment delay time.

[1] Wu Yue, Zhang Xiaoyu, Yu Mei, et al. Analysis of the episode of phlegm of patients with ST segment elevation myocardial infarction, China Cycle Journal, 2021, 36: 1070-1076. Doi: 10.3969 / j.issn .1000-3614.2021.11.003. [Long press or scan QR code can be seen in the original]

[2] 2019 Chinese adult acute ST segment elevation myocardial infarction medical quality control report. China Cycle Journal, 2020, 35 (4): 313-325. Doi: 10.3969 / j.issn.1000-3614.2020.04.001 [Long Press or scan the QR code to see the original]

Reprinted: Please indicate "China Cycle Magazine"

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