重组人尿激酶原联合硝普钠替罗非班冠状动脉内注射对高血栓负荷STEMI患者行PCI疗效的影响

Effect of Intracoronary Injection of Recombinant Human Prourokinase in Combination with Sodium Nitroprusside Tirofiban on the Efficacy of PCI in STEMI Patients with High Thrombotic Load

目的 分析重组人尿激酶原联合硝普钠替罗非班冠状动脉内注射对高血栓负荷急性ST段抬高型心肌梗死(ST-segment Elevation Myocardial Infarction,STEMI)患者行经皮冠状动脉介入治疗(Percutaneous Coronary Intervention,PCI)疗效的影响。方法 选取2022年1月—2023年6月连云港市中医院收治的82例需行PCI高血栓负荷STEMI患者为研究对象,按照随机数表法分为研究组和对照组,各41例。对照组应用硝普钠、替罗非班冠状动脉内注射,研究组在对照组基础上给予重组人尿激酶原治疗,对比两组心功能指标、出血事件发生情况、术后并发症发生情况。结果 术后各时间点,研究组左心室舒张末期内径低于对照组,左心室射血分数高于对照组,差异有统计学意义(P均<0.05)。研究组并发症发生率(9.76%)低于对照组(26.83%),差异有统计学意义(χ^(2)=3.998,P<0.05)。两组出血率比较,差异无统计学意义(P>0.05)。结论 重组人尿激酶原联合硝普钠、替罗非班冠状动脉内注射,能够提高高血栓负荷STEMI患者行PCI过程中的心功能,降低术后并发症,且不会增加出血风险。

Objective To analyze the effect of intracoronary injection of recombinant human prourokinase combined with sodium nitroprusside tirofiban on the efficacy of percutaneous coronary intervention(PCI) in patients of STsegment elevation myocardial infarction(STEMI) with high thrombus load.Methods 82 patients with high thrombus load STEMI admitted to Lianyungang Hospital of Traditional Chinese Medicine from January 2022 to June 2023 who needed PCI were selected as study objects,and were divided into study group and control group according to the randomized table method,with 41 cases in each group.In the control group,sodium nitroprusside and tirofiban were applied for intracoronary injection,and the study group was given recombinant human prourokinase on the basis of the control group.Cardiac function indexes,the occurrence of bleeding events,and the occurrence of postoperative complications were compared in the two groups.Results At each postoperative time point,the left ventricular end-diastolic internal diameter of the study group was lower than that of the control group,and the left ventricular ejection fraction was higher than that of the control group,and the differences were statistically significant(both P<0.05).The complication rate of the study group(9.76%) was lower than that of the control group(26.83%),and the difference was statistically significant(χ^(2)=3.998,P<0.05).There was no statistically significant difference in bleeding rate between the two groups(P>0.05).Conclusion Recombinant human prourokinase combined with sodium nitroprusside,tirofiban intracoronary injection,can improve the high thrombus load STEMI patients undergoing PCI process center function,reduce postoperative complications,and does not increase the risk of bleeding.