rhpro-UK冠状动脉内注射用于急性心肌梗死PCI治疗患者的临床效果

Clinical effect of coronary injection of rhpro-UK in patients with acute myocardial infarction after PCI

目的:探讨重组人尿激酶原(rhpro-UK)冠状动脉内注射对急性心肌梗死(AMI)经皮冠状动脉介入(PCI)治疗患者的影响。方法:将158例接受PCI治疗的AMI患者按照治疗方式不同分为观察组和对照组,每组各79例。对照组给予PCI治疗;观察组在对照组的基础上联合rhpro-UK冠状动脉内注射。比较两组患者治疗前后的心肌梗死溶栓试验(TIMI)血流分级、心功能、心肌酶谱、血清炎症因子、胱抑素C(Cys-C)及术后不良事件发生情况。结果:术毕即刻,观察组的TIMI血流分级为3级占比高于对照组(P<0.05)。术后1个月、3个月,观察组左心室射血分数(LVEF)均高于对照组,左心室舒张末期内径(LVDD)均低于对照组。术后1 d,观察组患者的心肌酶谱、炎症因子、Cys-C均低于对照组(P<0.05)。观察组不良心血管事件发生率低于对照组(P<0.05)。结论:rhpro-UK冠状动脉内注射可改善经PCI治疗AMI患者心脏血流和心功能,降低心肌酶、炎症因子和Cys-C水平,且可降低术后不良心血管事件的发生。

Objective:To explore the effects of coronary injection of human recombinant prourokinase(rhpro-UK)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods:A total of 158 patients with AMI undergoing PCI were enrolled and divided into observation group and control group according to different treatment methods,79 cases in each group.After PCI,observation group was given coronary injection of rhpro-UK.The blood flow grading in Thrombolysis In Myocardial Infarction(TIMI),cardiac function,myocardial enzymes,serum inflammatory factors,Cys-C and incidence of postoperative adverse events were compared between the two groups before and after treatment.Results:Immediately after surgery,TIMI blood flow grade 3 in observation group was higher than that in control group(P<0.05).At 1 and 3 months after surgery,left ventricular ejection fractions(LVEF)in observation group was higher than that in control group,while left ventricular end diastolic dimension(LVDD)was lower than that in control group.At 1 d after surgery,levels of myocardial enzymes,inflammatory factors and Cys-C in observation group were lower than those in control group(P<0.05).The incidence of adverse cardiovascular events in observation group was lower than that in control group(P<0.05).Conclusion:Coronary injection of rhpro-UK can improve cardiac blood flow and function,decrease levels of myocardial enzymes,inflammatory factors and Cys-C,and reduce the incidence of postoperative adverse cardiovascular events in patients with AMI after PCI.