靶血管内注射重组人尿激酶原对急性心肌梗死PCI术后心肌微灌注及心脏不良事件的影响

Effect of Target Intravascular Injection of Recombinant Human Prourokinase on Myocardial Microperfusion and Adverse Cardiac Events after PCI for Acute Myocardial Infarction

目的探究靶血管内注射重组人尿激酶原对急性心肌梗死经皮冠脉介入术(PCI)术后心肌微灌注及心脏不良事件的影响。方法60例2018年5月至2019年5月本院收治的急性心肌梗死患者,根据入院顺序及单双数法分为对照组(n=30)、观察组(n=30)。两组均接受PCI治疗,观察组在此基础上接受重组人尿激酶原治疗。统计两组治疗后临床疗效;比较两组患者治疗前后心肌微灌注、心功能指标及心脏不良事件发生率的差异。结果与治疗前相比,治疗后两组TIMI血流计数(CTFC)、TIMI心肌灌注分级(TMPG)降低,且观察组低于对照组(P<0.05);术后心脏不良事件发生率差异均无统计学意义(P>0.05)。观察组术前TIMI3级血流比例、术后ST段回落比例、左心室射血分数(LVEF)均高于对照组,左心室舒张末径(LVEDD)、氨基末端脑钠尿肽(NT-proBNP)低于对照组(P均<0.05)。结论重组人尿激酶原可有效缓解急性心肌梗死PCI术后患者临床症状,改善心肌微灌注,且疗效优于常规PCI治疗,值得临床推广应用。

Objective To explore the effect of injecting recombinant human prourokinase into target vessel on myocardial microperfusion and adverse cardiac events after percutaneous coronary intervention(PCI)for acute myocardial infarction.Methods Sixty patients with acute myocardial infarction admitted to our hospital from May 2018 to May 2019 were divided into the control group(n=30)and the observation group(n=30)according to the order of admission and the method of single and double numbers.Both groups were treated with PCI,and the observation group was treated with recombinant human prourokinase.The clinical efficacy of the two groups after treatment was counted.The differences of myocardial micro-perfusion,cardiac function indexes and the incidence of adverse cardiac events were compared between the two groups before and after treatment.Results Compared with before treatment,TIMI blood flow count(CTFC)and TIMI myocardial perfusion grade(TMPG)in the two groups decreased after treatment,and the observation group was lower than the control group(P<0.05).The incidence of cardiac adverse events after operation showed no difference(P>0.05).After treatment with recombinant human prourokinase,the number of TIMI3 blood flow cases in observation group before operation was higher than that in control group(P<0.05).Compared with before treatment,the proportion of ST segment falling and LVEF in the observation group were higher than those in the control group,while LVEDD and NT-proBNP in the observation group were lower than those in the control group(P<0.05).Conclusion Recombinant human prourokinase can effectively relieve the clinical symptoms of patients with acute myocardial infarction after PCI,improve myocardial micro-perfusion,and its curative effect is better than conventional PCI treatment,which is worthy of clinical application.