摘要
目的探讨重组人尿激酶原对急性下壁ST段抬高心肌梗死(ST segment elevation myocardial infarction,STEMI)患者急诊经皮冠脉介入术(percutaneous coronary intervention,PCI)中无复流或慢血流的影响。方法选取2022年1月至2023年12月于新沂市人民医院接受治疗的80例急性下壁STEMI患者。将患者分为两组,每组40例。其中,对照组患者经导管推注100μg硝酸甘油或硝普钠后实施PCI;观察组患者在对照组基础上经导管推注20mg重组人尿激酶原至梗死相关动脉后实施PCI。采用心肌梗死溶栓(thrombolysis in myocardial infarction,TIMI)血流分级法比较两组患者的术后即刻心肌灌注情况。结果两组患者术中即刻TIMI血流分级比较,0~1级:观察组1例(2.5%),对照组7例(17.5%),两组比较差异有统计学意义(P<0.05);2级:观察组3例(7.5%),对照组8例(20.0%),两组比较差异无统计学意义(P>0.05);3级:观察组36例(90.0%),对照组25例(62.5%),两组比较差异有统计学意义(P<0.05)。结论重组人尿激酶原可有效改善急性下壁STEMI患者急诊PCI中梗死相关动脉的冠脉血流情况,改善心肌供血不足,且不增加出血等不良反应,对改善患者预后具有重要意义。
Objective To explore the clinical efficacy of recombinant human prourokinase during emergency coronary intervention(PCI)in patients with acute inferior wall ST segment elevation myocardial infarction(STEMI)without reflow or slow blood flow.Methods Eighty patients with acute inferior wall STEMI admitted to Xinyi People’s Hospital from January 2022 to December 2023 were selected.The patients were divided into two groups,40 cases in each group.The control group patients accepted PCI after receiving 100μg nitroglycerin or nitroprusside via catheter;On the basis of control group,the observation group patients received 20mg recombinant human prourokinase via catheter until infarct related artery,and PCI was performed.Using thrombolysis in myocardial infarction(TIMI)blood flow grading method,compared the immediate myocardial perfusion after surgery.Results Comparison of immediate TIMI blood flow grading between two groups of patients during surgery,with grades ranging from level 0 to 1:1 case(2.5%)in observation group and 7 cases(17.5%)in control group.The difference between two groups was statistically significant(P<0.05);Level 2:3 cases(7.5%)in observation group and 8 cases(20.0%)in control group.There was no statistically significant difference between two groups(P>0.05);Level 3:36 cases(90.0%)in observation group and 25 cases(62.5%)in control group.The difference between two groups was statistically significant(P<0.05).Conclusion Recombinant human prourokinase can effectively improve the coronary blood flow of infarct related artery during emergency PCI in patients with acute inferior wall STEMI,improve myocardial ischemia,and do not increase adverse reactions such as bleeding,which is of great significance for improving patient’s prognosis.
作者
王芳
马龙
何洋洋
冯浩
朱晓彤
雍辉
WANG Fang;MA Long;HE Yangyang;FENG Hao;ZHU Xiaotong;YONG Hui(Cardiovascular Medicine Ward(1),Xinyi People’s Hospital,Xinyi 221400,Jiangsu,China;Department of Cardiovascular Medicine,the Fifth People’s Hospital of Huai’an,Huai’an 223300,Jiangsu,China)
出处
《中国现代医生》
2024年第30期79-82,共4页
China Modern Doctor
关键词
重组人尿激酶原
梗死相关动脉
经皮冠脉介入术
心肌梗死溶栓血流分级法
Recombinant human prourokinase
Infarction related artery
Percutaneous coronary intervention
Thrombolysis in myocardial infarction blood flow grading method
