冠状动脉注射尿激酶原与瑞替普酶对急性心肌梗死患者炎症因子及出血事件的影响  

Effect of coronary injection of prourokinase versus reteplase on inflammatory factors and bleeding events in patients with acute myocardial infarction

作　　者：何智学 任强 王煜[1] 任波 He Zhi-xue;Ren Qiang;Wang Yu;Ren Bo(Department of Emergency Medicine,Yingshan Hospital Affiliated to West China Hospital,Sichuan University,Nanchong 637700,China)

机构地区：[1]四川大学华西医院营山医院(营山县人民医院)急诊医学科,南充637700

出　　处：《中国药物应用与监测》2024年第5期528-531,共4页Chinese Journal of Drug Application and Monitoring

摘　　要：目的 探究冠状动脉注射尿激酶原与瑞替普酶对急性心肌梗死(AMI)患者炎症因子及出血事件的影响。方法 选取四川大学华西医院营山医院2021年9月至2023年9月AMI患者94例,根据随机数字表法分为观察组、对照组,各47例。对照组给予冠状动脉注射瑞替普酶,观察组给予冠状动脉注射尿激酶原。对比两组患者心肌灌注情况、炎症因子、出血事件及不良心血管事件。结果 治疗后,观察组血流分级(TIMI)1级、2级及3级的患者比例为17.02%(8/47)、17.02%(8/47)、65.96%(31/47),对照组TIMI1级、2级及3级的患者比例为8.51%(4/47)、19.15%(9/47)、72.34%(34/47),两组比较差异无统计学意义(U=0.842,P=0.400)。治疗后,观察组高敏C反应蛋白、白细胞介素-6及肿瘤坏死因子-α水平[分别为(2.93±1.01) mg·L^(-1)、(10.43±4.16) ng·L^(-1)、(112.67±21.36) ng·L^(-1)],与对照组[分别为(3.19±1.22) mg·L^(-1)、(11.67±4.54) ng·L^(-1)、(119.48±22.32) ng·L^(-1)]比较差异均无统计学意义(t=1.125、1.381、1.511,均P>0.05);治疗后,观察组轻度出血及不良心血管事件发生率分别为6.38%(3/47)、8.51%(4/47)均低于对照组的21.28%(10/47)、23.40%(11/47)(χ^(2)=4.374、3.887,均P<0.05),但中度出血事件发生率观察组为2.13%(1/47),对照组为6.38%(3/47),两组比较差异无统计学意义(χ^(2)=0.261,P=0.609)。结论 冠状动脉注射尿激酶原与瑞替普酶对AMI患者的心肌灌注效果相当,炎症改善作用相当,尿激酶原相较于瑞替普酶安全性更高。Objective To investigate the effect of intracoronary injection of prourokinase versus reteplase on inflammatory factors and bleeding events in patients with acute myocardial infarction(AMI).Methods Ninety-four AMI patients admitted to Yingshan Hospital Affiliated to West China Hospital from September 2021 to September 2023 were enrolled in this study and divided into the control group and observation group according to the random number table method,with 47 in each group.The patients in the observation group were given intracoronary injection of prourokinase while those in the control group that of reteplase.Then the vascular perfusion,inflammatory factors,bleeding events and major adverse cardiovascular events were compared between the two groups.Results After treatment,the proportion of patients with TIMI grades 1,2,and 3 was 17.02%(8/47),17.02%(8/47)and 65.96%(31/47)in the observation group and 8.51%(4/47),19.15%(9/47)and 72.34%(34/47)in the control,showing no statistically significant difference(U=0.842,P=0.400).The levels of high-sensitivity C-reactive protein,interleukin-6 and tumor necrosis factor-αwere(2.93±1.01)mg·L^(-1),(10.43±4.16)ng·L^(-1) and(112.67±21.36)ng·L^(-1) in the observation group and(3.19±1.22)mg·L^(-1),(11.67±4.54)ng·L^(-1) and(119.48±22.32)ng·L^(-1) in the control,demonstrating that there were no statistically significant differences between the two groups(t=1.125,1.381,1.511,all P>0.05).The incidence of mild bleeding events and major adverse cardiovascular events were 6.38%(3/47)and 8.51%(4/47)in observation group,which was lower than that of 21.28%(10/47)and 23.40%(11/47)in the control(χ^(2)=4.374,3.887,both P<0.05).However,the incidence of moderate bleeding events was 2.13%(1/47)in the observation group and 6.38%(3/47)in the control group,indicating that there was no statistically significant difference between the two groups(χ^(2)=0.261,P=0.609).Conclusion The clinical effect of intracoronary injection of prourokinase and reteplase for AMI patients is comparable in vasc

关 键 词：冠状动脉注射 尿激酶原 瑞替普酶 急性心肌梗死 炎症因子 出血事件 

分 类 号：R542.22[医药卫生—心血管疾病] R969[医药卫生—内科学]