摘要
目的:探讨尿激酶原联合血栓抽吸治疗高血栓负荷的STEMI患者的有效性与安全性。方法:选择2015年3月—2019年3月在我院行经皮冠状动脉介入治疗(PCI)术治疗的70例高血栓负荷STEMI患者,按照不同的术中血栓治疗方案分为对照组(血栓抽吸+病变近端注入替罗非班,35例)与观察组(尿激酶原联合血栓抽吸,35例),对比两组患者的临床效果。结果:观察组中TMPG分级为3级与术后ST段回落的患者明显多于对照组(P<0.05),且c TFC记帧帧数也明显低于对照组(P<0.05);观察组患者的CK-MB峰值及cTnI峰值均明显低于对照组患者(P<0.05);观察组患者在术后的左室射血分数明显高于对照组患者(P<0.05);两组患者的不良事件发生情况并无较大差异(P>0.05)。结论:尿激酶原联合血栓抽吸治疗高血栓负荷STEMI患者的疗效确切,可有效提高其术后心肌组织灌注水平,降低无复流的发生率,且不会引起心脏不良事件及出血风险的升高,具有较高的可行性与安全性。
Objective: To investigate the clinical effect of urokinase combined with thrombus aspiration in STEMI patients with high thrombus burden. Methods: Seventy patients with high thrombus burden STEMI who underwent percutaneous coronary intervention(PCI) in our hospital from March 2015 to March 2019 were selected and divided into control group(thrombus aspiration+tirofiban injection proximal to the lesion, 35 cases) and observation group(urokinase combined with thrombus aspiration, 35 cases) according to different intraoperative thrombus treatment schemes, and the clinical effects of the two groups were compared. Results: In the observation group, the patients with TMPG grade 3 and post-operative ST-segment depression were significantly more than those in the control group(P<0.05). And the frame number of cTFC was also significantly lower than that of the control group(P<0.05);The peak values of CK-MB and cTnI in the observation group were significantly lower than those in the control group(P < 0.05);The left ventricular ejection fraction in the observation group was significantly higher than that in the control group(P<0.05);There was no significant difference in the occurrence of adverse events between the two groups(P > 0.05). Conclusion: The application of urokinase combined with thrombus aspiration in the clinical treatment of STEMI patients with high thrombus load can effectively improve the myocardial perfusion level and reduce the incidence of no-reflow, and will not cause adverse cardiac events and increased risk of bleeding. It has high feasibility and safety.
作者
雷锐
刁中极
胡天琪
李志
LEI Rui;DIAO Zhongji;HU Tianqi;LI Zhi(Jiamusi Central Hospital Department Three of Cardiology,Jiamusi,Heilongjiang Province 154002;Jiamusi Central Hospital Department Two of Cardiology,Jiamusi,Heilongjiang Province 154002)
出处
《中国药物滥用防治杂志》
CAS
2021年第3期332-335,348,共5页
Chinese Journal of Drug Abuse Prevention and Treatment
关键词
尿激酶原
血栓抽吸
ST段抬高型心肌梗死
高血栓负荷
心肌指标
Urokinase
Thrombus aspiration
ST-segment elevation myocardial infarction
High thrombus load
Myocardial index
