摘要
(1)目的观察超选择性冠脉内应用重组人尿激酶原对补救性经皮冠状动脉介入治疗(PCI)患者的疗效。(2)方法选取连续就诊于唐山市工人医院行补救性PCI的58例患者为研究对象,其中男42例,女16例。随机分为尿激酶原组(PCI术中经抽吸导管于冠脉靶病变远端注射重组人尿激酶原联合血栓抽吸)30例与对照组(PCI术中经抽吸导管于冠脉靶病变处行血栓抽吸)28例。比较两组患者术前心功能KILLIP分级、TIMI 0级血流人数、左室射血分数(LVEF)及左室舒张末期内径(LVEDD);术后TIMI 3级血流人数、校正的TIMI血流帧数(CTFC)、2小时ST段回落情况及术后30天LVEF、LVEDD、主要不良心血管事件(MACE)和出血事件等发生的差异。(3)结果两组患者在年龄、性别、高血压、糖尿病、高脂血症、吸烟等一般资料及罪犯血管、植入支架数量等手术资料方面均无统计学意义(P>0.05);两组术后2小时心电图ST段回落情况、CTFC、TIMI 3级血流人数及术后30天LVEF、LVEDD比较,差异均有统计学意义(P <0.05),术后30天MACE事件发生率、出血情况均无统计学意义(P>0.05)。(4)结论补救性PCI患者冠脉内应用重组人尿激酶原可以有效改善心肌组织灌注,降低MACE事件且不增加出血风险。
Objective To observe the effect of recombinant human pro-urokinase in the treatment of rescue Percutaneous Coronary Intervention(PCI)in patients with superselective coronary artery.Methods A total of 58 consecutive patients visited in Tangshan Gongren Hospital were studied for rescue PCI,including 42 males and 16 females.They were randomly divided into pro-urokinase group(intraoperative PCI with aspiration catheter for distal injection of recombinant human pro-urokinase combined with thrombus aspiration)in 30 patients and control group(Percutaneous aspiration of coronary target lesions with aspiration catheter during PCI)in 28 cases.The KILLIP score,TIMI 0 blood flow,left ventricular ejection fraction(LVEF),and left ventricular end-diastolic dimension(LVEDD)were compared between the two groups before operation;the number of TIMI grade 3 blood flow,corrected TIMI blood flow after operation were compared.Number of Corrected TIMI Frame Count(CTFC),2h ST-segment fall,and 30-day postoperative LVEF,LVEDD,major adverse cardiovascular events(MACE),and bleeding events.Results There was no statistical difference between the two groups in terms of age,gender,hypertension,diabetes,hyperlipidemia,smoking and other general data,and the number of culprit vessels and the number of implanted stents(P>0.05).The ST-segment fall of electrocardiogram at 2h,CTFC and TIMI-3 blood flow and LVEF and LVEDD at 30 days after operation were statistically significant(P<0.05).There was no significant difference in the incidence of MACE events and bleeding after 30 days(P>0.05).Conclusion The use of recombinant human pro-urokinase in coronary artery in rescue PCI patients can effectively improve myocardial perfusion,reduce MACE events without increasing the risk of bleeding.
作者
安雪聪
宁海珊
姚家雪
张岱曦
刘晓堃
AN Xuecong;NING Haishan;YAO Jiaxue;ZHANG Daixi;LIU Xiaoukun(Graduate School,North China University of Science and Technology,Tangshan 063000,China)
出处
《华北理工大学学报（医学版）》
2018年第6期421-425,429,共6页
Journal of North China University of Science and Technology：Health Sciences Edition
