摘要
目的评价冠状动脉腔内注射重组人尿激酶原对急性ST段抬高心肌梗死(STEMI)高血栓负荷冠状动脉介入(PCI)治疗效果的影响。方法选择2016年8月至2018年12月就诊于安徽医科大学附属六安医院诊断STEMI并接受急诊PCI的冠状动脉高血栓负荷病人126例,采用随机数字表法分为对照组与观察组,对照组65例应用抽吸导管抽吸血栓,冠状动脉腔内注射盐酸替罗非班,观察组61例应用抽吸导管抽吸血栓,冠状动脉腔内注射替罗非班及重组人尿激酶原。观察两组临床疗效及安全性。结果观察组在靶血管TIMI3级血流[59(96.7%)例比51(78.5%)例]、术后2 h ST段回落百分比[28(45.9%)例比17(26.2%)例]优于对照组(P<0.05),靶血管无复流/慢血流发生率低于对照组[2(3.3%)例比10(15.4%)例,P<0.01]。3个月时观察组LVEF[(52±8)%比(44±9)%]、LVEDd[(46±4)mm比(59±6)mm]优于对照组(均P<0.05)。两组3个月内MACE发生率及出血例数差异无统计学意义(P>0.05)。结论重组人尿激酶原对急性ST段抬高心肌梗死高血栓负荷病人明显改善预后,减少心血管事件的发生,疗效可靠且安全。
Objective To evaluate the effect of recombinant human urokinase on interventional therapy of acute st-segment elevation myocardial infarction(STEMI)with high thrombus load.Methods One hundred and twenty-six patients with high coronary thrombosis who were diagnosed with STEMI and emergency PCI in Lu’an Hospital Affiliated to Anhui Medical University from August 2016 to December 2018 were selected and assigned into control group and observation group by random number table.65 cases in the control group were treated with aspiration catheter and tirofiban hydrochloride,while 61 cases in the observation group were treated with combination of aspiration catheter,tirofiban and recombinant human urokinase.Clinical efficacy and safety were observed.Results Timi3-grade blood flow in target vessels[59(96.7%)vs.51(78.5%)]and the percentage of fall of ST segment at 2 h after operation[28(45.9%)vs.17(26.2%)]in the observation group were better than those in the control group(P<0.05),and the incidence of no reflow/slow blood flow in target vessels[2(3.3%)vs.10(15.4%)]in the observation group was lower than that in the control group(P<0.01).At 3 months,LVEF[(52±8)% vs.(44±9)%]and LVEDd[(46±4)mm vs.(59±6)mm]of the experimental group were better than those of the control group(P<0.05).The incidence of MACE in the observation group was lower than that in the control group within 3 months,but there was no statistical significance(P>0.05).The number of bleeding cases was not statistically significant(P>0.05).Conclusion Recombinant human urokinase can significantly improve the prognosis and reduce the incidence of cardiovascular events in patients with acute st-segment elevation myocardial infarction and high thrombus load.
作者
冯俊
余世成
孙召金
丁胜楷
张亮
黄海涛
FENG Jun;YU Shicheng;SUN Zhaojin;DING Shengkai;ZHANG Liang;HUANG Haitao(Department of Cardiovascular Medicine,Lu’an Hospital Affiliated to Anhui Medical University,Lu’an,Anhui 237000,China)
出处
《安徽医药》
CAS
2020年第8期1624-1627,共4页
Anhui Medical and Pharmaceutical Journal
基金
安徽省公益性研究联动立项课题(1704f0804045)。
关键词
心肌梗死/药物疗法
注射
动脉内
重组人尿激酶原
高血栓负荷
冠状动脉介入治疗
Myocardial infarction/drug therapy
Injections
intra-arterial
Recombinant human urokinase
High thrombotic load
Coronary intervention
