【摘 要】 目的 进一步认识重组组织型纤溶酶原激活剂(rt-PA)与尿激酶(UK)静脉溶栓治疗急性心肌梗死(AMI)疗效和安全性的差异。 方法 应用Meta分析方法对11项rt-PA与UK静脉溶栓治疗AMI的对照研究进行同质性检验和合并效应量的检验。 结果 rt-PA组与UK组两组间冠状动脉再通率、出血并发症、心律失常及病死率的所有对照研究均具有同质性(均P>0.05)。rt-PA组的冠状动脉再通率为79.0%，显著高于UK组的55.6%(P<0.005)，而出血并发症、心律失常的发生率及病死率均与UK组相似(P>0.75或P>0.25)。 结论 rt-PA静脉溶栓治疗AMI的疗效显著优于UK，小剂量rt-PA(50mg)费用不高，适合在国内推广应用。

    【关键词】 急性心肌梗死;重组组织型纤溶酶原激活剂;尿激酶;静脉溶栓;Meta分析

    Meta-analysis:Intravenous Thrombolysis with Recombinant Tissue Plasminogen Activator vs Urokinase in Treatment of Acute Myocardial Infarction HE Rongzhong

    * ，JIANGYabin.

    * Dongguan Shijie People's Hospital，Dongguan 523290，China

    【Abstract】 Objective To further recognize the differences of efficacy and safety of intravenous thrombolysis with recombinant tissue plas-minogen activator(rt-PA)vs urokinase(UK)in treatment of acute myocardial infarction(AMI).Methods The efficacy and safety of intravenous thrombolysis with rt-PA vs UK in treatment of patients with AMIwere analyzed by meta-analysis in homogeneity test and combined test in11studies.Results Homogeneity test showed that the cited studies were homogeneous with P>0.05in the re-open rate of infarct related artery(IRA) ......