重组人尿激酶原联合依诺肝素治疗急性ST段抬高型心肌梗死的有效性和安全性研究  

Efficacy and safety of recombinant human prourokinase combined with enoxaparin in the treatment of acute ST segment elevation myocardial infarction

作　　者：翟晓娟 李莉 郭任维 高胜利 李建国 任艳琴 Zhai Xiaojuan;Li Li;Guo Renwei;Gao Shengli;Li Jianguo;Ren Yanqin(Department of Cardiology,Fenyang Hospital,Fenyang 032200,China;不详)

机构地区：[1]山西省汾阳医院心内科,汾阳032200 [2]山西医科大学汾阳学院生理教研室

出　　处：《中国临床保健杂志》2022年第3期333-336,共4页Chinese Journal of Clinical Healthcare

摘　　要：目的探讨重组人尿激酶原(pro-UK)联合依诺肝素治疗急性ST段抬高型心肌梗死(STEMI)的有效性和安全性。方法选取发病12 h内的STEMI患者118例作为研究组,给予pro-UK 20 mg静脉注射+30 mg静脉点滴,溶栓前30 min内静脉注射依诺肝素30 mg,15 min后皮下注射依诺肝素1 mg/kg,继以每12 h皮下注射1次至出院,最长8 d。以2012至2015年参加pro-UKⅣ期临床试验STEMI患者1851例作为对照组。观察2组间接再通率、直接再通率、出血发生率及住院期间主要心血管和死亡事件。结果研究组间接再通率85.6%,直接再通率67.6%;与对照组比较,差异均无统计学意义(P>0.05)。研究组轻微出血发生率6.78%,无严重出血发生;与对照组比较,差异无统计学意义(P>0.05)。研究组梗死后心绞痛发生率1.69%,无再梗死、再闭塞发生;与对照组比较,差异均有统计学意义(P<0.05);研究组病死率为4.24%,与对照组4.48%比较,差异无统计学意义(P>0.05)。结论pro-UK联合依诺肝素治疗STEMI具有安全、简便的特点。Objective To explore the efficacy and safety of recombinant human prourokinase(pro-UK)combined with enoxaparin in the treatment of acute ST segment elevation myocardial infarction(STEMI).Methods One hundred and eighteen patients with STEMI within 12 hours after onset from August 2017 to February 2020 were selected as the study group.They were given pro-UK 20 mg i.v.and 30 mg i.v.GTT.30 mg enoxaparin was injected within 30min before thrombolysis,and 1 mg/kg enoxaparin was subcutaneously injected 15 min later,followed by subcutaneous injection every 12 hours until discharge,up to 8 days.1851 STEMI patients who participated in proUK phase IV clinical trial from 2012 to 2015 were selected as control group.The indirect recanalization rate,direct recanalization rate,bleeding rate,major cardiovascular and death events during hospitalization were observed.Results The indirect recanalization rate and direct recanalization rate of the study group were 85.6%and 67.6%,respectively.There was no significant difference compared with the control group(P>0.05).The incidence of minor bleeding in the study group was 6.78%,and no serious bleeding occurred.Compared with the control group,the difference was not statistically significant(P>0.05).The incidence of angina pectoris after infarction in the study group was 1.69%.There was no re-infarction and reocclusion in the study group,with statistical difference compared with the control group(P<0.05).The mortality rate of the study group was 4.24%,and there was no significant difference compared with 4.48%of the control group(P>0.05).Conclusions ProUK combined with enoxaparin in the treatment of STEMI is effective,safe and simple.

关 键 词：ST段抬高型心肌梗死 依诺肝素 尿激酶型纤溶酶原激活物 纤维蛋白溶解药 

分 类 号：R54[医药卫生—心血管疾病]