重组人尿激酶原联合尼可地尔靶血管灌注对接受PCI治疗的急性心肌梗死患者的影响

Effect of Recombinant Human Pro-urokinase Combined with Nicorandil Target Perfusion on Patients with Acute Myocardial Infarction Treated with PCI

目的观察重组人尿激酶原(rhPro-UK)联合尼可地尔靶血管灌注对接受经皮冠状动脉介入术(PCI)治疗的急性心肌梗死(AMI)患者的影响。方法使用随机双盲法将2019年1月至2021年1月在商水县人民医院行PCI治疗的90例AMI患者分为对照组(n=45)和观察组(n=45)。两组均行PCI治疗,给予对照组rhPro-UK靶血管灌注,给予观察组rhPro-UK联合尼可地尔靶血管灌注。比较两组手术前后心肌梗死溶栓试验(TIMI)血流分级、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、心肌肌钙蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)、丙二醛(MDA)、超氧化物歧化酶(SOD)水平,统计两组术后主要不良心血管事件(MACE)发生率。结果观察组术后TIMI血流分级改善情况优于对照组(P<0.05);观察组术后7d、1个月时的LVEDD水平低于对照组,而LVEF水平高于对照组(P<0.05);观察组术后1、7d时的cTnT、CK-MB水平低于对照组(P<0.05);观察组术后1、7d时的MDA水平低于对照组,而SOD水平高于对照组(P<0.05);观察组术后6个月内MACE发生率(4.44%)较对照组(17.78%)低(P<0.05)。结论rhPro-UK联合尼可地尔靶血管灌注可有效改善行PCI治疗的AMI患者的TIMI血流分级和心功能,且能减轻术后心肌损伤和氧化应激损伤,能有效降低术后MACE发生风险。

Objective To observe the effect of recombinant human pro-urokinase(rhPro-UK)combined with nicorandil target perfusion on patients with acute myocardial infarction(AMI)treated with percutaneous coronary intervention(PCI).Methods Ninety patients with AMI who underwent PCI in Shangshui People's Hospital from January 2019 to January 2021 were divided into control group(n=45)and observation group(n=45)using a randomized double-blind method.Both groups were treated with PCI,and the control group was injected with rhPro-UK,and the observation group was injected with rhPro-UK combined with nicorandil.Thrombolysis in myocardial infarction(TIMI)blood flow grade,left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),cardiac troponin T(cTnT),creatine kinase isoenzyme(CK-MB),malondialdehyde(MDA)and superoxide dismutase(SOD)levels were compared between the two groups before and after operation.The incidence of major adverse cardiovascular events(MACE)in the two groups was analyzed.Results The improvement of TIMI blood flow grading in the observation group after operation was better than that in the control group(P<0.05).The LVEDD level of the observation group was lower than that of the control group at 7 days and 1 month after operation,while the LVEF level was higher than that of the control group(P<0.05).The cTnT and CK-MB levels of the observation group were lower than those of the control group at 1 and 7 days after operation(P<0.05).The MDA level of observation group was lower than that of control group at 1 and 7 days after operation,while SOD level was higher than that of control group(P<0.05).The incidence of MACE 6 months after operation in the observation group(4.44%)was lower than that in the control group(17.78%)(P<0.05).Conclusion RhPro-UK combined with nicorandil target perfusion can effectively improve TIMI blood flow grading and cardiac function in AMI patients treated with PCI,alleviate postoperative myocardial injury and oxidative stress injury,and effectively reduce the risk of postoperative MACE.