重组人尿激酶原不同给药方式对急性STEMI患者左室功能及同步性的影响  

Influence of different administration methods of recombinant human prourokinase on left ventricular function and cardiac synchrony in patients with acute ST-segment elevation myocardial infarction

作　　者：任珊 刘华长 李雅超 杨东红[4] 李青[5] 张英[5] Ren Shan;Liu Huachang;Li Yachao;Yang Donghong;Li Qing;Zhang Ying(First Department of Ultrasound,People's Hospital of Langfang City,Langfang 065000,China)

机构地区：[1]廊坊市人民医院超声一科,廊坊065000 [2]廊坊市人民医院心内二科,廊坊065000 [3]廊坊市人民医院心内一科,廊坊065000 [4]廊坊市人民医院心内三科,廊坊065000 [5]廊坊市人民医院急诊科,廊坊065000

出　　处：《中国循证心血管医学杂志》2023年第4期470-472,476,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河北省廊坊市科技支撑计划项目(2021013114)。

摘　　要：目的 探讨重组人尿激酶原不同给药方式对急性ST段抬高型心肌梗死(STEMI)患者左室功能及同步性的影响。方法 选择2021年3月至2022年9月于廊坊市人民医院收治的急性STEMI患者100例,采用随机数表法分为A、B两组,每组各50例。两组患者均接受经皮冠状动脉介入治疗(PCI),A组术中分3次注射重组人尿激酶原,B组术中一次性注射重组人尿激酶原。比较两组即刻心肌梗死溶栓试验(TIMI)分级,术前及术后1个月左室基底段纵向应变(LS)、心尖段LS、中间段LS、左室整体纵向应变(GLS)、左室射血分数(LVEF)、18个节段达峰时间的最大-最小值差(Tp-diff)和标准差(TpSD),并比较术后1周出血事件发生率及术后3个月主要不良心脏事件(MACE)发生率。结果 两组术后TIMI血流分级比较,差异无统计学意义(P>0.05);术后1个月,A组基底段、心尖段、中间段LS、GLS、LVEF、Tp-diff、Tp-SD均高于B组,差异具有统计学意义(P<0.05);两组术后出血事件发生率、MACE发生率比较,均无统计学意义(P>0.05)。结论 分次注射重组人尿激酶原治疗急性STEMI能较好地改善左室功能及同步性,但在改善心肌灌注、降低MACE发生率方面未体现出明显优势。Objective To discuss the influence of different administration methods of recombinant human prourokinase(rh-proUK)on left ventricular function and cardiac synchrony in patients with acute ST-segment elevation myocardial infarction(STEMI).Methods The patients with acute STEMI(n=100)were chosen from People's Hospital of Langfang City from Mar.2021 to Sept.2022,and divided into group A and group B(each n=50)by using digital table method.All patients in 2 groups were received percutaneous coronary intervention(PCI),and then group A was given the injection of rh-proUK for 3 times,and group B was given one-time injection of rhproUK.The grades of immediate thrombolysis in myocardial infarction(TIMI),and left ventricular basal longitudinal strain(LS),left ventricular global longitudinal strain(LVGLS),apical LS,mid LS,left ventricular ejection fraction(LVEF),and maximum to minimum difference(Tp-diff)and standard deviation(Tp-SD)of peak time of 18 segments before and 1-month after PCI were compared between 2 groups.The incidence rates of bleeding events after PCI for 1 week,and incidence rates of major adverse cardiovascular events(MACE)after PCI for 3 months were compared between 2 groups.Results The difference in TIMI flow grading had no statistical significance between 2 groups(P>0.05).After PCI for 1 month,the left ventricular basal LS,apical LS,mid LS,LVGLS,LVEF,Tp-diff and Tp-SD were all higher in group A than those in group B(P<0.05).The comparisons in incidence rates of bleeding events and incidence rates MACE after PCI had no statistical significance between 2 groups(P>0.05).Conclusions The fractional injection of rh-proUK can improve left ventricular function and cardiac synchrony in acute STEMI treatment,while which does not show significant advantages in improving myocardial perfusion and reducing MACE incidence.

关 键 词：急性ST段抬高型心肌梗死 主要不良心脏事件 重组人尿激酶原 心功能 

分 类 号：R542.22[医药卫生—心血管疾病]