重组人尿激酶原联合硝酸甘油对急性ST段抬高型心肌梗死经冠脉介入后无复流的疗效

目的 探讨重组人尿激酶原联合硝酸甘油对急性ST段抬高型心肌梗死(STEMI)患者经冠状动脉介入(PCI)后无复流的疗效.方法 选取2017年5月至2019年5月收治的急性STEMI患者82例,以随机数字表法分为对照组与观察组,各41例.对照组于梗死动脉的远端通过靶向灌注导管注入替罗非班联合硝酸甘油,后实施PCI治疗.观...

Effect of recombinant human prourokinase combined with nitroglycerin on no-reflow after percutaneous coronary intervention in patients with acute ST segment elevation myocardial infarction

Objective To explore the effects of recombinant human prourokinase(rhPro-Uk)combined with nitroglycerin on no-reflow after percutaneous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods Eighty-two patients with acute STEMI admitted to hospital from May 2017 to May 2019 were enrolled and randomly divided into control group and observation group(n=41,each).In control group,tirofiban with nitroglycerin was injected through a targeted perfusion catheter at the distal end of infarcted artery,and then PCI was performed.In observation group,nitroglycerin combined with rhPro-uk was injected through a targeted perfusion catheter at the distal end of infarcted artery,followed by PCI.No-reflow was judged as TIMI(Thrombolysis in Myocardial Infarction Trail)blood flow≤gradeⅡ.Myocardial perfusion,cardiac function,adverse cardiac events and bleeding events during hospitalization were compared between two groups.Results Compared with control group,TIMI flow grade was better(Z=2.338,P=0.019)and the incidence of no-reflow in observation group was lower(7.32%vs 26.83%,χ²=5.513,P=0.019),and the incidence of ST segment reduction>70%was higher(95.12%vs 78.05%,χ²=5.145,P=0.023)in observation group.Compared with control group,left ventricular end-systolic volume and left ventricular end-diastolic volume decreased,and left ventricular ejection fraction increased in observation group(P<0.01).The total incidence of adverse cardiac events in observation group was significantly lower than that in control group(4.88%vs 21.95%,χ²=4.770,P=0.029).There was no statistical difference in the incidence of bleeding events during hospitalization between two groups(P>0.05).Conclusion Compared with tirofiban,rhPro-UK combined with nitroglycerin injected through a targeted perfusion catheter to the distal end of infarcted artery in PCI for acute STEMI patients can canenhance the myocardial perfusion level,improve no-reflow condition and cardiac function,also reduce the risk of adverse cardiac events and bleeding events.