rhPro-UK及r-SAK治疗急性ST段抬高型心肌梗死的疗效与安全性评估  

Evaluation of Efficacy and Safety of Recombinant Human Prourokinase(rhPro-UK)、Recombinant Staphylokinase(r-SAK)in the Treatment of Acute ST-segment Elevation Myocardial Infarction

作　　者：杜思雨 韩炜[2] 杨扬 郑伟[2] 齐文华 DU Siyu;HAN Wei;YANG Yang;ZHENG Wei;QI Wenhua(Graduate School of Baotou Medical College,Baotou 014000 China;Department of Cardiology,Baotou Central Hospital,Baotou 014000 China)

机构地区：[1]包头医学院研究生院,内蒙古包头014000 [2]包头市中心医院心内科,内蒙古包头014000

出　　处：《内蒙古医学杂志》2023年第7期779-784,共6页Inner Mongolia Medical Journal

摘　　要：目的比较rhPro-UK及r-SAK溶栓治疗STEMI的有效性及安全性。方法选取2020年5月至2022年6月包头市中心医院心内科收治的符合AHA/ACC诊断标准且无溶栓禁忌证的STEMI患者71例,随机分为rhPro-UK组(35例)、r-SAK组(36例)后行静脉溶栓治疗,溶栓后90min行冠脉造影检查,对比两组患者的血管开通情况,评估疗效,同时观察记录STEMI患者溶栓后急性期并发症及各种不良事件、出血发生率,进行安全性评估。结果两组血管再通率(94.3%比88.9%,P=0.696)比较差异无统计学意义。两组急性期并发症、不良事件、出血发生率等方面差异均无统计学意义。rhPro-UK组溶栓后LVEF值高于r-SAK组,P=0.019。两组应用临床间接指标与行冠脉造影评判血管再通情况间比较差异无统计学意义。结论(1)对STEMI患者应用rhPro-UK、r-SAK均可有效使IRA开通,rhPro-UK血管开通率略优于r-SAK,但差异无统计学意义;(2)rhPro-UK、r-SAK不增加心律失常、心功能不全、再次梗死、出血等事件的发生风险,用于STEMI皆安全有效;(3)临床间接指标与行冠脉造影具有相似诊断IRA再通的价值。Objective To compare the efficacy and safety of rhPro-UK and r-SAK in the treatment of acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 71 STEMI patients who met AHA/ACC diagnostic criteria for acute myocardial infarction and had no thrombolytic contrainminations were enrolled in the cardiology Department of Baotou Central Hospital from May 2020 to June 2022,and were randomly divided into rhPro-UK group(n=35)and r-SAK group(n=36)to receive intravenous throm-bolytic therapy.Ninety minutes later,coronary angiography was performed to compare the vascular opening of the two groups.Meanwhile,the incidence of acute complications,various adverse events and bleeding in STE-MI patients after thrombolysis with the above drugs was observed and recorded,and the safety was evaluated.Results There was no significant difference in the rate of vascular recirculation between the two groups(94.3%vs.88.9%,P=0.696).There were no significant differences in acute complications,adverse events and bleeding rates between the two groups.The LVEF value of rhPro-UK group was higher than that of r-SAK group(P=0.019).There was no significant difference between the two groups in the application of clini-cal indirect indicators and the evaluation of vascular recanalization after coronary angiography.Conclusion(1)recombinant human urokinase and recombinant staphylokinase can effectively open IRA in STEMI patients,and the vascular opening rate of rhPro-UK is slightly higher than r-SAK,but there is no statistical significance.(2)rhPro-UK and r-SAK do not increase the risk of arrhythmia,cardiac insufficiency,reinfarction,bleeding and other events,and are safe and effective for STEMI.(3)clinical indicators and coronary angiography have similar value in diagnosing IRA recanalization.

关 键 词：急性ST段抬高型心肌梗死 葡激酶 尿激酶原 静脉溶栓 冠状动脉造影 血管再通率 

分 类 号：R543[医药卫生—心血管疾病]