尿激酶辅助PCI术治疗STEMI患者的疗效评价

Efficacy evaluation of urokinase-assisted PCI in the treatment of STEMI patients

目的:探究尿激酶(Urokinase,UK)辅助经皮冠状动脉介入术(Percutaneous coronary intervention,PCI)治疗急性ST段抬高型心肌梗死(ST-segment elevation myocardial infarction,STEMI)患者的效果。方法:回顾性收集2017年1月至2020年4月我院104例STEMI患者,按治疗方案不同分成A组、B组,各52例。B组接受PCI治疗,A组接受UK辅助PCI治疗。对比两组患者术后即刻心肌灌注情况、治疗前与治疗30 d后血清细胞因子指标、半乳糖凝集素-3(Galectin-3,Gal-3)、N末端脑钠肽元(N-terminal pro-brain natriuretic peptide,NT-proBNP)水平及心脏不良事件发生率等。结果:A组心肌梗死溶栓实验血流分级较B组优,ST段回落率较B组高,心脏不良事件发生率较B组低(P<0.05);与治疗前相比,各治疗组的血清白细胞介素-6、肿瘤坏死因子-α、NT-proBNP、GAL-3水平均明显降低(P<0.05),其中A组更为显著(P<0.05)。结论:UK辅助PCI术治疗STEMI患者能进一步改善心肌灌注情况,缓解炎性反应,促进病情恢复,降低心脏不良事件发生风险。

Objective:To investigate the effect of urokinase(UK)-assisted percutaneous coronary intervention(PCI)in the treatment of patients with acute ST-segment elevation myocardial infarction(STEMI).Methods:From January 2017 to April 2020,104 patients with STEMI in our hospital were retrospectively collected and divided into group A and group B according to different treatment plans,with 52 cases in each.Group B received PCI,and group A received UK adjuvant PCI.The myocardial perfusion conditions immediately after operation,serum cytokine indexes,Galectin-3(Gal-3)and N-terminal pro-brain natriureticpeptide(NT-proBNP)level,incidence of adverse cardiac events,etc were compared between the two groups before and 30 days after treatment.Results:Compared with group B,the blood flow grade of myocardial infarction thrombolysis experiment in group A was better than that in group B,the ST segment fall rate was higher than that in group B,and the incidence of cardiac adverse events was lower than that in group B(P<0.05).The serum levels of interleukin-6,tumor necrosis factor-α,NT-proBNP,and GAL-3 were significantly decreased(P<0.05),and group A was more significant(P<0.05).Conclusion:UK-assisted PCI in the treatment of STEMI patients can further improve myocardial perfusion,relieve inflammatory response,promote disease recovery,and reduce the risk of adverse cardiac events.