摘要
目的观察ST段抬高型心肌梗死(STEMI)患者行急诊PCI中应用冠状动脉内溶栓的有效性。方法选取行急诊PCI的STEMI患者139例,根据是否在行急诊PCI中经指引导管向冠状动脉内注入溶栓药物注射用重组人尿激酶原(20mg)分为观察组(61例)和对照组(78例)。对比2组校正的TIMI帧数计数(cTFC)、TIMI心肌灌注分级(TMPG)、ST段抬高总和回落百分比(sumSTR)、LVEF、左心室舒张末期内径(LVEDD)、不良心血管事件和住院期间出血事件的发生率。结果与术前比较,术后2组cTFC水平明显降低(P<0.01)。与对照组比较,观察组术后cTFC水平明显降低[(24.3±6.3)帧vs(30.5±6.8)帧,P=0.000],TMPG≥2级及sumSTR≥30%比例明显升高(77.1%vs 53.9%,P=0.005;91.8%vs 76.9%,P=0.019)。住院期间及随访30d,观察组LVEDD明显低于对照组,LVEF明显高于对照组,差异有统计学意义(P<0.05,P<0.01),2组不良心血管事件和住院期间出血事件发生率比较,无统计学差异(P>0.05)。结论对于STEMI患者,在行急诊PCI中应用冠状动脉内溶栓可改善左心功能及大小,且不增加不良心血管事件和出血事件的发生率。
Objective To study the curative effect of intracoronary thrombolysis in STEMI patients undergoing primary PCI.Methods One hundred and thirty-nine STEMI patients who underwent primary PCI were divided into control group(n=78)and observation group(n=61).Recombinant human prourokinase(20 mg)was injected into their coronary atery via a guiding catheter during primary PCI in observation group.The cTFC,TMPG,sumSTR,LVEF,LVEDD,inhospital incidence of MACE and bleeding events were compared between the two groups.Results The cTFC was significantly lower in two groups after primary PCI(P<0.01).The cTFC was significantly lower while the rates of TMPG≥2 and sumSTR≥30%were significantly higher in observation group than in control group(24.3±6.3 vs 30.5±6.8,P=0.000;77.1%vs 53.9%,P=0.005;91.8%vs 76.9%,P=0.019).The LVEDD was significantly shorter while the LVEF was significantly higher in observation group than in control group during the hospital stay time and the 30-day follow-up period(P<0.05,P<0.01).No significant difference was detected in incidence of MACE and inhospital bleeding envents between the two group(P>0.05).Conclusion Intracoronary thrombolysis can improve the function and size of left ventricle without increasing the incidence of MACE and bleeding events in STEMI patients undergoing primary PCI.
作者
张文艳
刘寅
肖健勇
高明东
李春洁
郑权秀
张伟杰
白杰
丛洪良
Zhang Wenyan;Liu Yin;Xiao Jianyong;Gao Mingdong;Li Chunjie;Zheng Quanxiu;Zhang Weijie;Bai Jie;Cong Hongliang(Tianjin Medical University Graduate School,Tianjin 300070,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2019年第11期1146-1149,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
天津市科技计划项目(16ZXMJSY00150)
关键词
心肌梗死
心肌再灌注
冠状血管造影术
myocardial infarction
myocardial reperfusion
coronary angiography
