硝普钠联合重组人尿激酶原对急性ST段抬高型心肌梗死患者经皮冠状动脉介入后无复流的效果观察  

Effect of Sodium Nitroprusside combined with recombinant human prourokinase on no-reflow after percutaneous coronary intervention in patients with acute ST-segment elevation myocardial infarction

作　　者：王永 胡晴[1] 王永军[1] 吕培 胡建军[1] 高江彦[1] WANG Yong;HU Qing;WANG Yong-jun;LYU Pei;HU Jian-jun;GAO Jiang-Yan(Department of Cardiology,Hebei Provincial Chest Hospital,Shijiazhuang 050041,China)

机构地区：[1]河北省胸科医院心内科,河北省石家庄市050041

出　　处：《中国心血管病研究》2020年第7期643-646,共4页Chinese Journal of Cardiovascular Research

基　　金：2018年度河北省医学科学研究重点课题计划(20181040)。

摘　　要：目的观察硝普钠联合重组人尿激酶原对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)后无复流的效果.方法本研究对象为2018年3月至2019年3月就诊于本院的80例行PCI术的急性STEMI患者,采取随机数字表法分为两组,各40例.对照组采用硝普钠治疗,研究组为硝普钠联合重组人尿激酶原治疗.比较两组患者的临床疗效、心肌梗死溶栓治疗(TIMI)心肌灌注分级(TMPG)与校正的TIMI血流帧数计数(cTFG)、炎性因子以及不良事件发生率.结果研究组的治疗总有效率(92.50%)高于对照组(72.50%),用药后研究组TMPG(100.76±5.67)帧与cTFG(26.83±4.20)帧均低于对照组(105.29±6.03)帧、(30.76±5.59)帧,治疗7 d后的白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)和内皮细胞特异性分子1(ESM-1)水平低于对照组,不良事件发生率(15.00%)比对照组(35.00%)低,差异有统计学意义(P<0.05).结论硝普钠联合重组人尿激酶原对急性STEMI患者行PCI术后无复流的治疗效果较强,可以有效改善患者的TMPG,降低炎性反应,减少无复流以及不良事件的发生率.Objective To observe the effect of Sodium Nitroprusside combined with recombinant human prourokinase on no-reflow after percutancous coronary intervention(PCI)in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods Eighty patients with acute STEMl who underwent PCl in the Hospital from March 2018 to March 2019 were enrolled in the study.They were randomly divided into two groups,with 40 cases in each group.The control group was treated with Sodium Nitroprusside and the study group was treated with sodium nitroprussidc combined with recombinant human prourokinase.The clinical efficacy,thrombolysis in myocardial infarction(TIMI)myocardial perfusion grading(TMPG)and corrected TIMl frame count(cTFG),inflammatory factors and incidence of adverse events were compared between the two groups.ResultsThe total effective rate of treatment in the study group(92.50%)was higher than that in the control group(72.50%).After treatment,the numbcrs of TMPG and cTFG were(100.76±5.67)and(26.83±4.20)frames in the study group,both shown to be lower than the control group,which were(105.29±16.03)and(30.76±5.59)frames,the levels of interlcukin-6(IL-6),high-sensitivity C-reactive protcin(hs-CRP)and endothelial cell-specific molecule 1(ESM-1)after 7 days of treatment were lower than the control group.The incidence of adverse events(15.00%)in the study group was lower than that in the control group(35.00%)and the difference was statistically significant(P<0.05).Conclusion For patients with acute STEMIl who underwent PCI,Sodium Nitroprusside combined with recombinant human prourokinase is with significant effect on non reflow,which can help improve TMPG and reduce inflammatory response and the incidence of no-reflow and adverse events.

关 键 词：心肌梗死 硝普钠 重组人尿激酶原 复流 

分 类 号：R542.2.2[医药卫生—心血管疾病]