摘要
目的评估经皮冠状动脉介入治疗(PCI)时,冠状动脉内注射重组人尿激酶原(rh-pro UK)对ST段抬高型心肌梗死(STEMI)患者高血栓负荷的影响。方法回顾性分析2018年1月至2020年1月于六安市人民医院行PCI的88例高血栓负荷STEMI患者的临床资料。根据患者PCI术中冠脉内用药的不同,将冠状动脉内注射替罗非班的43例患者作为对照组,冠状动脉内联合注射替罗非班和rh-pro UK的45例患者作为观察组。比较两组患者TIMI血流分级、TIMI心肌灌注分级(TMPG)、ST段回落百分比(STR)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、住院期间出血及主要不良心血管事件(MACE)发生情况。结果观察组患者TMPG 3级的比例为97.78%、STR>70%的比例为26.67%,均高于对照组,差异有统计学意义(P<0.05);观察组患者术后1个月LVEF、LVEDD改善,差异有统计学意义(P<0.05);两组患者TIMI分级、住院期间出血及MACE发生率比较,差异无统计学意义(P>0.05)。结论冠状动脉内注射rh-pro UK可更好地改善STEMI心肌灌注水平及左心室功能,同时不增加住院期间出血及MACE发生率。
Objective To evaluate the efficacy and safety of intracoronary injection of recombinant human prourokinase(rh-pro UK)in patients with ST segment elevation myocardial infarction(STEMI)with high thrombus load during percutaneous coronary intervention(PCI).Methods A retrospective analysis was made on 88 STEMI patients with high thrombus load who underwent PCI in Lu'an people's Hospital from January 2018 to January 2020.Among them,43 patients were treated with intracoronary injection of tirofiban as control group,and 45 patients with intracoronary combined injection of tirofiban and rh-pro UK as observation group.The TIMI flow grade,TIMI myocardial perfusion grade(TMPG),ST segment decline percentage(STR),LVEF,left ventricular end-diastolic diameter(LVEDD),in-hospital bleeding and major adverse cardiovascular events(MACE)were compared between the two groups.Results The proportion of TMPG=3 grade and STR>70%in the study group was 97.78%and 26.67%respectively,which was significantly higher than that in the control group(P<0.05).The LVEF and LVEDD of left ventricular function in the study group were improved 1 month after operation,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of TIMI grade,bleeding and MACE between the two groups(P>0.05).Conclusion Intracoronary injection of rh-pro UK can better improve the myocardial perfusion level and left ventricular function of STEMI without increasing the incidence of bleeding and MACE during hospitalization.
作者
赵广文
张燕
钱福东
ZHAO Guangwen;ZHANG Yan;QIAN Fudong(Graduate School of Bengbu Medical College,Bengbu 233030,China)
出处
《安徽医学》
2020年第10期1160-1163,共4页
Anhui Medical Journal
关键词
心肌梗死
重组人尿激酶原
经皮冠状动脉介入治疗
Myocardial infarction
Recombinant human prourokinase
Percutaneous coronary intervention
