摘要
目的探讨经皮腔内冠状动脉成形术(PTCA)联合尿激酶原对急性心肌梗死(AMI)患者心肌再灌注及预后的影响。方法连续入选2017年6月至2018年2月于南阳市中心医院心内科收治的AMI患者98例,随机分为PTCA组与联合组,每组49例。PTCA组给予PTCA治疗,联合组先行尿激酶原注射,后行PTCA治疗。评价两组患者术后心肌梗死溶栓(TIMI)血流分级、心肌灌注分级(TMP),检测肌酸激酶同工酶(CK-MB)水平。另外观察住院期间和出院后6个月发生主要不良心脏事件的情况。结果联合组PTCA后TIMI血流分级、TMP分级均显著优于PTCA组(P均<0.05)。与术前比较,两组术后12 h、24 h血清CK-MB水平均显著上升(P均<0.05);联合组术后12 h血清CK-MB水平显著低于PTCA组(P<0.05)。住院期间联合组再发心绞痛发生率4.08%,显著低于PTCA组的18.37%(P<0.05),出血率两组比较无显著差异(P>0.05)。联合组出院后6个月恶性心律失常发生率显著低于PTCA组(P<0.05)。结论PTCA联合尿激酶原能明显改善AMI患者心肌再灌注,且不增加出血风险,可有效减少不良心脏事件发生。
Objective To investigate the influence of percutaneous transluminal coronary angioplasty(PTCA)combined with prourokinase on myocardial reperfusion and prognosis in patients with acute myocardial infarction(AMI).Methods AMI patients(n=98)were chosen from Department of Cardiovascular Medicine in Central Hospital of Nanyang City from June 2017 to Feb.2018,and then randomly divided into PTCA group and combined group(each n=49).The PTCA group was treated with PTCA,and combined group was treated with prourokinase injection followed by PTCA.The indexes of TIMI flow grades,grades of TIMI myocardial perfusion(TMP)and level of creatine kinase-MB isoenzyme(CK-MB)were reviewed in 2 groups after PTCA.The incidence of major adverse cardiovascular events(MACE)was observed in 2 groups during hospitalization period and 6 months after discharged.Results The post-operative TIMI flow grades and TMP grades were significantly superior in combined group to those in PTCA group after PTCA(all P<0.05).Compared with before PTCA,the level of serum CK-MB increased significantly in 2 groups after PTCA for 12 h and 24 h(all P<0.05).The level of serum CK-MB was significantly lower in combined group than that in PTCA group after PTCA for 12 h(P<0.05).The incidence rate of re-attack angina pectoris was 4.08%in combined group and 18.37%in PTCA group(P<0.05),while bleeding rate had no significant difference between 2 groups(P>0.05)during hospitalization period.The incidence rate of malignant arrhythmia was significantly lower in combined group than that in PTCA group(P<0.05)after discharged for 6 months.Conclusion PTCA combined with prourokinase can significantly improve myocardial reperfusion without increasing bleeding risk and effectively reduce MACE in AMI patients.
作者
刘志远
张金盈
刘江波
赵晓宁
刘飞
李纲
李玉东
Liu Zhiyuan;Zhang Jinying;LiuJiangbo;Zhao Xiaoning;Liu Fei;Li Gang;Li Yudong(Department of Cardiovascular Medicine,Central Hospital of Nanyang City,Henan Province,Nanyang 473009,China;不详)
出处
《中国循证心血管医学杂志》
2019年第12期1491-1494,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
郑州大学第一附属医院跨学科协同攻关博士科研团队基金(2016-BSTDJJ-19)
关键词
经皮腔内冠状动脉成形术
尿激酶原
急性心肌梗死
心肌再灌注
预后
Percutaneous transluminal coronary angioplasty
Prourokinase
Acute myocardial infarction
Myocardial reperfusion
Prognosis
