经球囊导管冠状动脉内注射尿激酶原对急性STEMI患者心肌灌注的疗效  

Efficacy of myocardial perfusion with intracoronary injection of prourokinase by balloon catheter in STEMI patients

作　　者：刘净敏 耿巍[2] 田祥[2] 张旗 甄利波[2] 张博涵[2] 赵灿[1] 

机构地区：[1]承德医学院,河北承德067000 [2]保定市第一中心医院心内二科,河北保定071000

出　　处：《临床荟萃》2016年第11期1192-1196,共5页Clinical Focus

摘　　要：目的评价经球囊导管途径冠状动脉内注射尿激酶原对急性ST段抬高型心肌梗死(STEMI)患者心肌灌注的疗效。方法选取STEMI并行急诊冠状动脉介入(PPCI)治疗的患者135例,随机分为两组,即尿激酶原组(试验组,66例)和对照组(69例)。试验组通过球囊导管于病变处注射尿激酶原10mg(10ml),对照组给予同等剂量的生理盐水。比较两组基本临床资料、校正TIMI帧数(cTFC)、心肌组织灌注(TMPG)分级、术后2小时ST段回落率(≥50%)、室壁运动积分及室壁运动积分指数、术后7天及1月的左室射血分数(LVEF)等指标的差异。结果两组基本资料差异无统计学意义(P>0.05)。两组校正TIMI帧数(cTFC)、心肌组织灌注(TMPG)分级,术后2小时ST段回落率(≥50%)、室壁运动积分及室壁运动积分指数、术后7天及1月LVEF等情况比较差异有统计学意义(P<0.05)。结论经球囊导管冠状动脉内注射尿激酶原可以改善急性STEMI患者的心肌组织灌注。Objective To evaluate the effect of myocardial perfusion of STEMI（ST-segment elevation myocardial infarction）patients who underwent intracoronary injection of prourokinase by balloon catheter.Methods A total of 135 STEMI patients who underwent primary PCI were enrolled and depending on whether use of prourokinase they were randomly divided into two groups,test group（pro-urok inase group,n =66）and control group（n =69）.The test group got injected prourokinase 10mg（10ml）by expanding the balloon at the occlusion,the control group received the same dose of saline.The basic clinical data,corrected TIMI frame count（cTFC）,myocardial tissue perfusion grading（TMPG）,ST resolution≥50% at 2hours,wall motion score and score index after seven days and left ventricular ejection fraction（LVEF）on day 7and 30 were recorded and analyzed.Results The basic clinical data between two groups had no significant differences（P〉0.05）.cTFC,TMPG,ST resolution ≥50% at 2hours,wall motion score and wall motion score index,LVEF on day 7and 30 had significant differences between two groups（P〈0.05）.Conclusion Intracoronary administration of prourokinase through balloon castheter could improve myocardium perfusionin STEMI patients who underwent emergency PCI.

关 键 词：心肌梗死 球囊导管 尿激酶原 校正TIMI帧数 心肌组织灌注分级 

分 类 号：R542.22[医药卫生—心血管疾病]