| 杨广龙,周会霞,杨波.重组人尿激酶原联合经皮冠状动脉介入术对急性ST段抬高型心肌梗死患者近期预后的影响[J].安徽医药,2018,22(12):2453-2456. |
| 重组人尿激酶原联合经皮冠状动脉介入术对急性ST段抬高型心肌梗死患者近期预后的影响 |
| Effect of rhPro-UK combined with percutaneous coronary intervention on the short-term prognosis of patientswith acute ST-segment elevation myocardial infarction |
| 投稿时间：2017-03-20 |
| DOI： |
| 中文关键词: 重组人尿激酶原 经皮冠状动脉介入术 急性ST段抬高型心肌梗死 预后 |
| 英文关键词: Recombinant human Pro urokinase Percutaneous coronary intervention Acute ST-segment elevation myocardial infarction Prognosis |
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| 中文摘要: |
| 目的 探讨重组人尿激酶原(rhPro-UK)联合经皮冠状动脉介入术(PCI)对急性ST段抬高型心肌梗死(STEMI)患者近期预后的影响。 方法 将90例STEMI患者采用随机数字表法分为rhPro-UK+PCI组45例和PCI组45例,两组患者均行冠状动脉造影和PCI术,rhPro-UK+PCI组在PCI术前单次或反复多次向冠脉内注射rhPro-UK,然后进行血栓抽吸,rhPro-UK用量根据动脉造影血流情况,5～10万U/次,总剂量≤50万U。两组患者随访30 d,记录两组患者心肌灌注、心功能及主要心脏不良事件(MACE),并检测患者血清肌酸激酶同工酶(CK-MB)和超敏C反应蛋白(hs-CRP)水平。 结果 rhPro-UK+PCI组TIMI Ⅲ级比例和术后90 min ST段回落＞70%比例显著高于PCI组,CTFC显著低于PCI组,组间比较差异有统计学意义(P＜0.05)。围术期两组患者CK-MB逐渐上升,至术后12 h达峰值,此后逐渐降低；hs-CRP逐渐上升,至术后3 d达峰值,此后逐渐降低。术后12、24、36、48 h rhPro-UK+PCI组CK-MB水平显著低于PCI组,术后3、5 d rhPro-UK+PCI组hs-CRP 水平显著低于PCI组(P＜0.05)。rhPro-UK+PCI组LVEF显著高于PCI组,LVEDV、LVESV显著低于PCI组(P＜0.05)；术后rhPro-UK+PCI组MACE发生率低于PCI组。 结论 STEMI患者PCI术前冠脉内给予rhPro-UK能够显著改善心肌再灌注,提高心功能,并且具有较高的安全性。 |
| 英文摘要: |
| Objective To explore the short-term prognosis of rhPro-UK combined with percutaneous coronary intervention (PCI) in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 90 cases of STEMI patients according to the random number table method were divided into rhPro-UK+PCI group with 45 cases and PCI group with 45 cases.The two groups underwent coronary angiography and PCI.The rhPro-UK+PCI group were single or repeated injected of urokinase,and then thrombus aspiration was carried.The dosage of urokinase were according to angiography blood flow,5-10 WU/times,and the total dose was less than 50 WU.Two groups of patients were followed up for 30 d,of which the myocardial perfusion,cardiac function and MACE were recorded,and the serum CK-MB and hs-CRP level were detected. Results The TIMI Ⅲ grade ratio and falling degree >70% of ST segment elevation at 90 min after intervention ratio in rhPro-UK+PCI group was significantly higher than PCI group.CTFC was significantly lower than the group,the difference between the two groups was statistically significant (P<0.05).During the perioperative period,the CK-MB of the two groups increased gradually,and decreased gradually after reached the peak at 12 h.Hs-CRP gradually increased and gradually decreased after reaching the peak after 3D.After 12,4,36,8 h of intervention CK-MB level was significantly lower than the PCI group,after 3,5 d of intervention hs-CRP level was significantly lower than the PCI group (P<0.05).The LVEF in rhPro-UK+PCI group was significantly higher than PCI group,LVESV and LVEDV were significantly lower than PCI group (P<0.05).The incidence of MACE in rhPro-UK+PCI group was significantly lower than that in PCI group. Conclusion In patients with STEMI,injection of rhPro-UK in coronary artery before PCI significantly improve myocardial reperfusion,cardiac function,and with higher safety. |
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