血栓抽吸导管联合小剂量重组人尿激酶原在老年急性ST段抬高型心肌梗死急诊PCI中的应用价值  

Application Value of Thrombus Aspiration Catheter Combined with Low-dose Recombinant Human Prourokinase in Emergency PCI in Elderly Patients with Acute ST-segment Elevation Myocardial Infarction

作　　者：王慧 李永健[1] WANG Hui;LI Yong-jian(Department of Cardiology,Tianjin Nankai Hospital,Tianjin,300110,China)

机构地区：[1]天津市南开医院心内科,天津300110

出　　处：《黑龙江医学》2022年第2期153-155,共3页Heilongjiang Medical Journal

摘　　要：目的:探讨血栓抽吸导管联合小剂量重组人尿激酶原在老年急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入术(PCI)中应用的有效性及安全性。方法:回顾性分析天津市南开医院2019年2月—2020年2月确诊并行急诊的90例STEMI老年患者,按治疗方法不同,分为观察组和对照组,每组各45例。观察组:血栓抽吸+10 mg尿激酶原+PCI治疗。对照组:血栓抽吸+PCI治疗。比较两组患者术后心肌梗死溶栓治疗(TIMI)血流分级、TIMI心肌灌注显影(TMPG)分级、2 h ST段回落率、随访主要心血管不良事件及主要出血事件发生率。结果:(1)PCI术后心肌灌注:观察组在TIMI血流3级,TMPG 3级、2 h ST段回落>70%比例均明显高于对照组。(2)主要心脏不良事件:观察组在心绞痛、心力衰竭发生率方面明显少于对照组。其他心血管不良事件发生率低于对照组。(3)出血事件:两组患者在出血发生率方面,差异无统计学意义(χ^(2)=0.090,P>0.05)。结论:血栓抽吸导管联合小剂量尿激酶原在老年STEMI患者PCI治疗中,可以有效改善心肌灌注,提高患者生存质量,安全性高,且相对减少患者治疗费用。Objective:To investigate the efficacy and safety of thrombus aspiration catheter combined with low-dose recombinant human prourokinase in PCI of elderly patients with acute st-segment elevation myocardial infarction(STEMI).Methods:90 elderly STEMI patients were retrospectively selected.According to different treatment methods,they were divided into observation group and control group,with 45 cases in each group.The observation group was treated with thrombus aspiration+10 mg prourokinase+PCI,and the control group was treated with thrombus aspiration+PCI.The postoperative TIMI blood flow classification,TMPG classification,2-hour ST segment fall rate,follow-up major adverse cardiovascular events,and major bleeding events were compared between the two groups.Results:(1)Comparison of myocardial perfusion after PCI:The proportion of TIMI blood flow level 3,TMPG level 3,and 2 h ST segment fall in the observation group was significantly higher than that of the control group.(2)Major adverse cardiac events:The observation group had significantly less incidence of angina pectoris and heart failure than the control group.The incidence of other cardiovascular adverse events was lower than that of the control group.(3)Bleeding events:There was no statistically significant difference in the incidence of bleeding between the two groups of patients(χ^(2)=0.090,P>0.05).Conclusion:Thrombus aspiration catheter combined with low-dose prourokinase can effectively improve myocardial perfusion in elderly STEMI patients with PCI treatment,improve the patients’quality of life,have high safety,and relatively reduce patient treatment costs.

关 键 词：血栓抽吸导管 急性ST段抬高型心肌梗死 重组人尿激酶原 

分 类 号：R542.22[医药卫生—心血管疾病]