重组人尿激酶原联合替罗非班在高血栓负荷ASTEMI患者PCI中的临床应用  

Clinical application of Recombinant Human Prourokinase combined with Tirofiban in PCI of ASTEMI patients with high thrombus burden

作　　者：罗江宾 冯旭霞[1] 陈其敬[1] 王天松[1] 何喜民[1] LUO Jiangbin;FENG Xuxia;CHEN Qijing;WANG Tiansong;HE Ximin(Department of Internal Medicine-Cardiovascular,Sanya People′s Hospital,Hainan Province,Sanya 572000,China)

机构地区：[1]海南省三亚市人民医院心内科

出　　处：《中国医药导报》2019年第26期129-132,136,共5页China Medical Herald

基　　金：海南省自然科学基金项目（310184）

摘　　要：目的研究重组人尿激酶原(rhPro-UK)联合替罗非班在高血栓负荷急性ST段抬高型心肌梗死(ASTEMI)患者经皮冠状动脉介入治疗(PCI)中的临床应用效果。方法选择2017年6月~2018年5月在海南省三亚市人民医院接受PCI治疗的93例高血栓负荷的ASTEMI患者进行研究。按照随机数字表法将患者分成观察组(47例)和对照组(46例),两组均给予常规PCI治疗。对照组通过抽吸导管在病变冠脉的远端缓慢注射替罗非班,观察组则在对照组的基础上再予以rhPro-UK治疗。比较两组治疗前及治疗2周后的心功能指标、血流相关指标、主要不良心血管事件(MACE)和不良反应发生情况。结果与治疗前比较,两组治疗后左室射血分数明显升高,左室舒张末期内径和左室收缩末期内径显著降低,差异有统计学意义(P <0.05)。观察组治疗后心肌梗死溶栓治疗(TIMI)血流分级3级和心肌灌注分级3级的比例明显高于对照组,校正的TIMI血流帧数显著低于对照组,差异有统计学意义(P <0.05)。观察组MACE和不良反应发生情况与对照组比较,差异无统计学意义(P> 0.05)。结论 rhPro-UK与替罗非班联合应用于经PCI治疗的高血栓负荷状态ASTEMI患者中,所得疗效较好,预后安全性较高,对患者心功能及血流状况均具有良好的改善作用,值得临床推广。Objective To investigate the clinical application of Recombinant Human Prourokinase (rhPro-UK) combined with Tirofiban in percutaneous coronary intervention (PCI) of patients with high thrombus burden and acute ST-segment elevation myocardial infarction (ASTEMI). Methods A total of 93 patients with high thrombus burden ASTEMI who underwent PCI at the Sanya People′s Hospital from June 2017 to May 2018 were enrolled. The patients were divided into observation group (47 cases) and control group (46 cases) according to the random number table method. The patients in both groups were given conventional PCI treatment. The control group was slowly injected with Tirofiban at the distal end of the coronary artery by aspiration catheter, while the observation group was treated with rhPro-UK on the basis of the control group. Cardiac function indicators, blood flow related indicators, the incidence of major adverse cardiovascular events (MACE) and adverse reactions were compared between the two groups before and after 2 weeks of treatment. Results Compared with before treatment, the left ventricular ejection fraction in the two groups was significantly increased after treatment, while the left ventricular end-diastolic diameter and left ventricular end-systolic diameter were significantly lower, and the differences were statistically significant (P < 0.05). The proportion of thrombolysis in myocardial infarction (TIMI) in blood flow grade 3 and myocardial perfusion grade 3 in the observation group after treatment were significantly higher than those in the control group, while the corrected TIMI blood flow frame count was significantly lower than the control group, and the differences were statistically significant (P < 0.05). There were no significant differences in the incidence of MACE and adverse reactions between the observation group and the control group, and the differences were not statistically significant (P > 0.05). Conclusion rhPro-UK combined with Tirofiban in ASTEMI patients with high thrombus burden who un

关 键 词：重组人尿激酶原 替罗非班 高血栓负荷 急性ST段抬高型心肌梗死 经皮冠状动脉介入治疗 应用效果 

分 类 号：R542.22[医药卫生—心血管疾病]