关键词: 半量瑞替普酶静脉溶栓, 急性心肌梗死, 血流动力, 循环内皮细胞, 安全性

Abstract: Objective　To study the effects of intravenous thrombolysis with half-dose reteplase on hemodynamics, circulating endothelial cells (CEC), and safety in patients with acute myocardial infarction (AMI). Methods　A total of 90 AMI patients admitted to Affiliated Hospital of Yan 'an University from January 2020 to January 2022 were collected and were divided into a control group (urokinase treatment) and a study group (half-dose reteplase treatment) according to different treatment drugs, with 45 patients in each group. There were 27 males and 18 females in the study group, aged (57.12±8.47) years; there were 29 males and 16 females in the control group, aged (56.24±9.31) years. The incidences of cardiovascular events and complications in the two groups were detected. The revascularization rate was observed at 0.5 h, 1.0 h, 1.5 h, and 2.0 h after intervention. The echocardiography was used to detect the hemodynamic related indicators in the two groups, the Perooll method was used to separate and count the CEC, and the radioimmunoassay was used to detect the level of endothelin-1 (ET-1). t test, χ² test, and Fisher exact test were used. Results　There were no statistically significant differences in the levels of mean left atrial pressure (mLAP), mean pulmonary arterial pressure (mPAP), and malignant mitral valve prolapse (mMVP) between the two groups before treatment (all P>0.05), but the levels of mLAP, mPAP, and mMVP decreased after treatment (all P<0.05), and the decrease was more significant in the study group (all P<0.05). There were no statistically significant differences in the levels of ET-1 and CEC between the two groups before treatment (both P>0.05), but the levels of ET-1 and CEC in the two groups decreased after treatment (all P<0.05), and the decrease was more significant in the study group (both P<0.05). The revascularization rate in the study group was higher than that in the control group at different time points [26.67% (12/45) vs. 6.67% (3/45), 35.56% (16/45) vs. 13.33% (6/45), 60.00% (27/45) vs. 33.33% (15/45), 77.78% (35/45) vs. 51.11% (23/45); all P<0.05]. There were no statistically significant differences in the incidences of cardiovascular events and complications between the two groups (all P>0.05). Conclusion　Intravenous thrombolysis with half-dose reteplase can improve the hemodynamics in patients with AMI, improve the vascular endothelial cell injury by inhibiting CEC expression, and has a low complication rate, which is safe for the treatment of AMI.

Key words: Intravenous thrombolysis with half-dose reteplase, Acute myocardial infarction, Hemodynamics, Circulating endothelial cells, Safety