急性ST段抬高型心肌梗死尿激酶原选择性冠状动脉内溶栓联合介入治疗与直接冠状动脉内介入治疗的对比研究  

Comparative study of urokinase-selective intracoronary thrombolysis combined with interventional therapy and direct percutaneous coronary intervention in acute ST segment elevation myocardial infarction

作　　者：李磊 李会晓 Li Lei;Li Huixiao(Department of Cardiovascular Medicine,Gongyi People's Hospital,Gongyi 451200,China)

机构地区：[1]巩义市人民医院心血管内科,河南巩义451200

出　　处：《临床荟萃》2020年第8期693-696,共4页Clinical Focus

基　　金：郑州市科技项目急性脑梗死静脉溶栓治疗在基层医院的应用与推广(2019KJHM0004)。

摘　　要：目的探讨急性ST段抬高型心肌梗死(STEMI)选择性冠状动脉内溶栓联合介入治疗与直接冠状动脉内介入治疗的疗效。方法2018年10月-2019年10月就诊于巩义市人民医院STEMI患者61例,采用随机单盲方法分为对照组(直接PCI)、治疗组(溶栓+PCI),纳入对照组31例,治疗组30例。观察两组冠状动脉血管TIMI血流分级、N末端B型利钠肽原(NT-ProBNP)水平、左心室射血分数(LVEF)值和住院期间病死率、再梗死率、出血事件发生率。结果治疗后,治疗组TIMI血流分级提高优于对照组(P<0.05)。结论冠状动脉内溶栓后介入治疗对比直接冠状动脉内介入治疗,更能改善患者心肌灌注水平,减少无复流的发生率,且同样能改善心功能和未增加住院期间出血事件的发生率。Objective To investigate the efficacy of selective intra-coronary thrombolysis combined with interventional therapy and direct intra-coronary intervention on acute ST segment elevation myocardial infarction(STEMI).Methods From October 2018 to October 2019,a total of 61 STEMI patients admitted to Gongyi People's Hospital were divided into control group(direct PCI,n=31)and treatment group(thrombolysis+PCI,n=30)by a randomized and single-blind method.TIMI blood flow grading,N-terminal pro-B-type natriuretic peptide(NT-ProBNP)level,left ventricular ejection fraction(LVEF)value,mortality during hospitalization,reinfarction rate and incidence of bleeding events were observed in two groups.Results After treatment,the TIMI blood flow grading in treatment group was better than that of control group(P<0.05).Conclusion Compared with direct intra-coronary thrombolysis,interventional therapy after intra-coronary thrombolysis can better improve the myocardial perfusion level in patients,reduce the incidence of no-reflow,improve cardiac function and not increase the incidence of bleeding during hospitalization.

关 键 词：心肌梗死 尿纤溶酶原激活物 冠状动脉 溶栓 放射学 介入性 

分 类 号：R541.4[医药卫生—心血管疾病]