尿激酶原溶栓联合急诊经皮冠状动脉介入术对ST段抬高型心肌梗死患者的影响

Effect of urokinase thrombolysis combined with emergency percutaneous coronary intervention in patients with ST segment elevation myocardial infarction

目的探讨尿激酶原溶栓联合急诊经皮冠状动脉介入术(PCI)对急性ST段抬高型心肌梗死(STEMI)患者的影响。方法将150例STEMI患者随机分为对照组和观察组,每组75例。对照组采用急诊PCI治疗,观察组采用尿激酶原溶栓联合急诊PCI治疗。比较2组心肌梗死溶栓试验(TIMI)血流分级、心肌灌注和心功能水平。结果术后,观察组TIMI血流分级为3级的患者比率为85.33%,ST段回落患者比率为90.67%,TIMI心肌灌注分级(TMPG)3级患者比率为68.00%,分别高于对照组的69.33%、72.00%、52.00%;TIMI帧数(CTFC)低于对照组,差异有统计学意义(P<0.05)。术后1、3个月,观察组左心室舒张末期内径(LVEDD)低于对照组,左心室射血分数(LVEF)高于对照组,差异有统计学意义(P<0.05)。结论采用尿激酶原溶栓联合急诊PCI治疗可改善急性STEMI患者心肌微循环血流灌注和心功能。

Objective To investigate the effect of urokinase thrombolysis combined with percutaneous coronary intervention (PCI) in patients with acute ST segment elevation myocardial infarction (STEMI). Methods A total of 150 STEMI patients were randomly divided into control group and observation group,with 75 cases in each group. The control group was treated with emergency PCI,while the observation group was treated with urokinase thrombolysis combined with emergency PCI.Blood grading of thrombolysis in myocardial infarction (TIMI),myocardial perfusion and cardiac function levels of the two groups were compared in the two groups. Results Ratio of patients with the TIMI level 3 blood flow in the observation group was 85. 33%,ratio of patients with the ST-segment regression was 90. 67%,and ratio of patients with the TMPG level 3 blood flow was 68. 00%,which were higher than those in the control group (69. 33%,72. 00% and 52. 00%,respectively);the Corrected TIMI Frame Count (CTFC) was significantly lower than the control group (P < 0. 05). At 1 and 3 months after surgery,the left ventricular end-diastolic diameter (LVEDD) in the observation group was significantly lower than that in the control group,and the left ventricular ejection fraction (LVEF) was significantly higher than that in the control group (P < 0. 05). Conclusion Thrombolytic therapy by urokinase combined with emergency PCI can improve myocardial microcirculation perfusion and cardiac function in patients with acute STEMI.