急性心肌梗死行冠脉内尿激酶原溶栓治疗效果及其远期预后危险因素分析

Analysis of the Efficacy and Long-term Prognostic Risk Factors of Intracoronary Urokinase Thrombolysis for Acute Myocardial Infarction

目的:探讨急性心肌梗死行冠脉内尿激酶原溶栓治疗效果及其远期预后危险因素。方法:选取2020.3-2022.3收治的200例急性心肌梗死患者行冠脉内尿激酶原溶栓治疗,对比疗效指标。随访2年后,将发生心血管不良事件的38例患者归为预后不良组,其余162例为预后良好组,分析远期预后危险因素。结果:再通率为95.00%,其中81.00%完全再通;且治疗期间无严重脑部出血,轻度出血率6.00%;心衰发生率6.50%,无心源性死亡。2年后随访发现,远期心血管不良事件发生率为19.00%;预后良好组与预后不良组患者年龄、发病到溶栓治疗时间、合并糖尿病、高脂血症、高血压、NYHA心功能分级、吸烟史、冠脉病变支数、梗死位置、缺血范围计分对比有差异(P<0.05);年龄、发病到溶栓治疗时间、NYHA心功能分级、冠脉病变支数、梗死位置、缺血范围计分为远期预后的独立危险因素(P<0.05)。结论:急性心肌梗死行冠脉内尿激酶原溶栓治疗效果显著,但远期预后受多因素影响,需重点关注高风险患者。

Objective:To investigate the effect of intracoronary urokininogen thrombolysis in acute myocardial infarction and its long-term prognosis risk factors.Methods:200 patients with acute myocardial infarction admitted to 2020.3-2022.3 were treated with internal coronary urokininogen thrombolysis to compare the efficacy index.After 2 years of follow-up,38 patients who had adverse cardiovascular events were classified in the poor prognosis group,and the remaining 162 patients were in the good prognosis group to analyze long-term prognosis risk factors.Results:The recanalization rate was 95.00%,with 81.00%complete recanalization;and no severe brain hemorrhage during treatment,mild bleeding rate 6.00%;heart failure rate 6.50%,no cardiac death.After follow-up after 2 years,the incidence of long-term cardiovascular adverse events was 19.00%;age,onset to thrombolytic therapy,diabetes,hyperlipidemia,hypertension,NYHA,smoking history,coronary lesions,infarction and ischemic range(P<0.05);age,onset to thrombolytic therapy,NYHA cardiac function grade,coronary,infarction,and ischemic range were classified as independent risk factors for long-term prognosis(P<0.05).Conclusion:However,the long-term prognosis is affected by many factors,on high-risk patients.