半量尿激酶原溶栓后早期PCI与延迟PCI治疗STEMI早期心功能的对比研究  

A comparative study on the effects of early PCI after half dose urokinase thrombolysis versus delayed PCI on early cardiac function in patients with STEMI

作　　者：李凡 陈晨 郭靖涛[2] 罗东雷[2] 周江[2] LI Fan;CHEN Chen;GUO Jingtao;LUO Donglei;ZHOU Jiang(Graduate School,Chengde Medical University,Hebei,Chengde 067000,China;Department of Cardiology,Chengde Central Hospital,Hebei,Chengde 067000,China)

机构地区：[1]承德医学院研究生院,河北承德067000 [2]河北省承德市中心医院心内科,河北承德067000

出　　处：《中国医药科学》2022年第5期1-5,共5页China Medicine And Pharmacy

基　　金：河北省承德市科学技术研究与发展计划项目(201804A013)。

摘　　要：目的通过对比观察半量尿激酶原溶栓联合早期经皮冠状动脉介入治疗(PCI)与延迟PCI对急性ST段抬高型心肌梗死(STEMI)患者早期心功能的影响,探讨STEMI患者行半量尿激酶原溶栓联合早期PCI治疗对早期心功能的疗效。方法随机选取2019年9月至2021年5月在承德市中心医院住院的50例行半量尿激酶原溶栓联合早期PCI治疗的STEMI患者为试验组,同时期的50例行延迟PCI治疗的STEMI患者为对照组,比较两组患者早期心功能的变化情况,包括脑钠肽(BNP)水平,患者入院时、出院前及出院后1个月的左心房内径(LAD)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)指标及出院后1个月内主要不良心血管事件发生情况。结果试验组患者在入院时LAD、LVEDD、LVEF指标与对照组比较,差异无统计学意义(P>0.05),试验组入院时BNP水平显著低于对照组,差异有统计学意义(P<0.05);试验组出院前LAD水平显著低于对照组,差异有统计学意义(P<0.05),两组LVEDD、LVEF指标比较差异无统计学意义(P>0.05);试验组出院后1个月LAD、LVEDD水平显著低于对照组,LVEF水平显著高于对照组,差异有统计学意义(P<0.05)。试验组出院后1个月内主要不良心血管事件发生情况与对照组比较,差异无统计学意义(P>0.05)。结论半量尿激酶原溶栓联合早期PCI较延迟PCI的STEMI患者在1个月内心脏结构及心脏功能的恢复有显著优势;随访两组患者出院后1个月内主要不良心血管事件发生情况未见明显差异。Objective To observe the effects of half-dose urokinase thrombolysis(HDUT)combined with early percutaneous coronary intervention(PCI)versus HDUT combined with delayed PCI on early cardiac function in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 50 patients with STEMI treated with HDUT combined with early PCI who were hospitalized in Chengde Central Hospital from September 2019 to May 2021 were randomly selected as the experimental group,and 50 patients with STEMI treated with delayed PCI during the same period were selected as the control group.The changes in early cardiac function,including the level of brain natriuretic peptide(BNP),the levels of left anterior descending coronary artery(LAD),left ventricular end-diastolic dimension(LVEDD)and left ventricular ejection fraction(LVEF)at admission,before discharge and 1 month after discharge,and the occurrence of major adverse cardiovascular events within 1 month after discharge was determined and compared between the two groups.Results There were no statistically significant differences between the exper imental group and the control group in the levels of LAD,LVEDD and LVEF at admission(P>0.05),and the BNP level in the experimental group was significantly lower than that in the control group at admission,with statistically significant differences(P<0.05).The LAD level in the experimental group was significantly lower than that in the control group before discharge,with statistically significant differences(P<0.05),and there were no statistically significant differences between the two groups in the levels of LVEDD and LVEF(P>0.05).LAD and LVEDD levels in the experimental group were significantly lower than those in the control group 1 month after discharge,and the LVEF level was significantly higher than that in the control group,with s tatistically significant differences(P<0.05).There were no statistically significant differences between the experimental group and the control group in the occurrence of major adverse c

关 键 词：急性ST段抬高型心肌梗死 经皮冠状动脉介入治疗 半量尿激酶原溶栓 心功能 

分 类 号：R542.22[医药卫生—心血管疾病]