PCI联合冠脉内注射重组人尿激酶原溶栓对急性心肌梗死患者的预后影响研究

Effect of PCI Combined with Intracoronary Injection of Recombinant Human Prourokinase Thrombolysis on the Prognosis of Patients with Acute Myocardial Infarction

目的探讨经皮冠状动脉介入(PCI)联合冠脉注射重组人尿激酶原溶栓治疗急性心肌梗死的临床效果。方法选取2019年12月至2021年5月我院收治的81例急诊PCI治疗的患者作为研究对象。根据再灌注治疗方式将患者分为试验组(n=43)和对照组(n=38)。试验组在患者靶血管部位注射重组人尿激酶原,对照组行血栓抽吸,比较两组的治疗效果。结果试验组术后TIMI血流分级结果显示:1级(无复流)低于对照组(P<0.05)。TIMI心肌灌注分级:试验组3级均于对照组(P<0.05)。试验组手术后30天LVEF高于对照组,LVVd、LVVs均低于对照组(P<0.05)。两组术后中远期(术后30天、1年)的心血管不良事件发生率无统计学意义(P>0.05)。结论PCI联合冠脉注射重组人尿激酶原溶栓治疗急性心肌梗死可有效改善患者的血流灌注,降低无复流的情况发生,对于患者预后的改善有一定的作用。

Objective To investigate the clinical effect of Percutaneous coronary intervention(PCI)combined with coronary injection of recombinant human prourokinase thrombolysis in the treatment of acute myocardial infarction.Methods 81 patients treated with emergency PCI in our hospital from December 2019 to May 2021 were selected as the research objects.The patients were divided into experimental group(n=43)and control group(n=38)according to the reperfusion treatment.The experimental group was injected with recombinant prourokinase at the target vascular site,and the control group was treated with thrombus aspiration.The therapeutic effects of the two groups were compared.Results The results of postoperative TIMI blood flow classification in the experimental group showed that the grade 1(no reflow)was lower than that in the control group(P<0.05).TIMI myocardial perfusion classification:grade3 in the experimental group were higher than those in the control group(P<0.05).At 30 days after operation,LVEF of experimental group was higher than that of control group,LVVd and LVVs were lower than those of control group(P<0.05).There was no significant difference in the mid-long term(30 days and 1 year after operation)incidence of adverse cardiovascular events between the two groups(P>0.05).Conclusion PCI combined with coronary injection of recombinant human prourokinase thrombolysis in the treatment of acute myocardial infarction can effectively improve the blood perfusion of patients,reduce the occurrence of no reflow,and play a certain role in improving the prognosis of patients.