不同浓度及作用部位重组人尿激酶原在STEMI介入中的应用疗效  

Curative effect of recombinant human prourokinase in different concentrations and at different effecting locations administrated in interventional therapy for STEMI

作　　者：王德良[1] 王新华[1] 裴建行[1] 贾涵铄 张苗苗 马光[1] 王海虹 Wang Deliang;Wang Xinhua;Pei Jianxing;Jia Hanshuo;Zhang Miaomiao;Ma Guang;Wang Haihong(First Department of Cardiology,Second Central Hospital of Baoding City,Hebei Province,Baoding 072750,China;不详)

机构地区：[1]保定市第二中心医院心内一科,保定072750

出　　处：《中国循证心血管医学杂志》2020年第12期1510-1513,1517,共5页Chinese Journal of Evidence-Based Cardiovascular Medicine

摘　　要：目的探讨不同浓度及作用部位重组人尿激酶原(rh-proUK)在STEMI介入中的疗效。方法选取保定市第二中心医院于2017年3月至2018年3月期间诊断为STEMI并拟行经皮冠状动脉介入治疗(PCI)的患者146例。第一阶段,将69例患者随机分为不同浓度组[对照组、10 mg rh-proUK组(A组)、20 mg rhproUK组(B组),各23例],将生理盐水,rh-proUK 10 mg、20 mg通过靶向灌注导管分别注入3组患者然后植入支架。第二阶段,将77例患者随机分为不同部位组[指引导管给药组(C组)35例和靶向导管给药组(D组)42例)],将rh-proUK 10 mg分别通过指引导管和靶向灌注导管注入两组患者中,然后植入支架。记录患者一般资料、血流恢复情况,心功能指标,主要不良心血管事件(MACE)发生率等。结果PCI后,B组CK-MB、cTnI的峰值时间均较A组提前(P<0.05),但两组术后血流恢复情况,心电图,心功能改善情况,MACE和出血事件发生率均无明显差异(P>0.05)。D组在术后血流恢复情况,心电图,心肌坏死标志物,心功能改善情况等均优于C组(P<0.05),MACE和出血事件发生率均无明显差异(P>0.05)。结论不同浓度rh-proUK在PCI术中具有相似的效果,给予10 mg rh-proUK可减轻STEMI患者的经济负担。与指引导管给药相比较,经靶向灌注导管给药可进一步改善STEMI患者PCI术的溶栓效果及预后情况。Objective To investigate the curative effect of recombinant human prourokinase(rh-proUK)in different concentrations and at different effecting locations administrated in interventional therapy for ST-segment elevation myocardial infarction(STEMI).Methods STEMI patients received planed PCI(n=146)were chosen from the Second Central Hospital of Baoding City from Mar.2017 to Mar.2018.At the first stage,69 patients were divided randomly into control group,group A(10 mg of rh-proUK)and group B(20 mg of rh-proUK,each n=23),and normal saline(control group),10 mg of rh-proUK(group A)and 20 mg of rh-proUK(group B)were respectively injected by targeted perfusion catheter followed by stenting.At the second stage,77 patients were divided randomLy into group C(guided catheter,n=35)and group D(targeted perfusion catheter,n=42),and rh-proUK(10 mg)was respectively injected in group C and group D by guided catheter and targeted perfusion catheter followed by stenting.The general materials,recovery of blood flow,indexes of heart function and incidence rate of major adverse cardiovascular events(MACE)were recorded.Results After PCI,the peak time of CK-MB and cTnI were earlier in group B than those in group A(P<0.05),but the differences in recovery of blood flow,ECG,heart function improvement and incidence rates of MACE and bleeding events were not significant between 2 groups(P>0.05).After PCI,the recovery of blood flow,ECG,myocardial necrosis biomarkers and heart function improvement were superior in group D to those in group C(P<0.05),and incidence rates of MACE and bleeding events had no significant difference between 2 groups(P>0.05).Conclusion Rh-proUK in different concentrations had similar curative effect during PCI,and 10 mg of rh-proUK can reduce the cost of STEMI patients.Compared with guided catheter,targeted perfusion catheter can further improve thrombolytic effect and prognosis in STEMI patients undergone PCI.

关 键 词：ST段抬高型心肌梗死 经皮冠脉介入治疗 重组人尿激酶原 

分 类 号：R542.22[医药卫生—心血管疾病]