rhTNK-tPA溶栓治疗对STEMI患者PCI术后并发症及心血管血流状态的影响研究  

To Study of the Effect of rhTNK-tPA Thrombolytic Therapy on Postop⁃erative Complications and Cardiovascular Blood Flow Status in STEMI Patients after PCI

作　　者：刘鸿斌 谢文韬[1] LIU Hongbin;XIE Wentao(Cardiovascular Department,Anxi County Hospital,Quanzhou,Fujian,362400,China)

机构地区：[1]安溪县医院心血管内科,福建泉州362400

出　　处：《中外医疗》2024年第30期1-4,9,共5页China & Foreign Medical Treatment

基　　金：安溪县医院2023年院级科研课题项目(2023006)。

摘　　要：目的 探讨注射用重组人TNK组织型纤溶酶原激活剂(recombinant human TNK tissue type plasminogen activator, rhTNK-tPA)溶栓治疗对ST段抬高型心肌梗死(ST segment elevation myocardial infarction, STEMI)患者经皮冠状动脉介入术(percutaneous coronary intervention, PCI)后的影响。方法 方便选取2021年1月—2024年2月安溪县医院收治的84例STEMI患者为研究对象,根据是否溶栓治疗分组,对照组40例未接受溶栓治疗,直接行PCI;观察组44例经rhTNK-tPA溶栓治疗后行PCI,比较两组术后并发症发生情况、心血管血流状态及凝血功能。结果 两组术后并发症发生率比较,差异无统计学意义(P>0.05)。术前,两组心肌梗死溶栓试验血流分级比较,差异无统计学意义(P>0.05);术后,观察组2级2.27%(1/44)、3级97.73%(43/44),均优于对照组的2级27.50%(11/40)、3级72.50%(29/40),差异有统计学意义(Z=10.889,P<0.05)。术前,两组凝血功能比较,差异无统计学意义(P>0.05);术后,观察组凝血酶原时间、凝血酶时间、部分活化凝血酶时间均长于对照组,纤维蛋白原低于对照组,差异有统计学意义(P均<0.05)。结论 rhTNK-tPA溶栓治疗不会增加STEMI患者PCI术后并发症,且能改善心血管血流状态与凝血功能。Objective To investigate the effect of recombinant human TNK tissue type plasminogen activator(rhTNK-tPA)thrombolytic therapy on patients with ST segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods A total of 84 patients with STEMI admitted to Anxi County Hospital from Janu⁃ary 2021 to February 2024 were conveniently selected as the research objects.According to whether thrombolytic therapy was performed,40 patients in the control group did not receive thrombolytic therapy and underwent PCI di⁃rectly;44 patients in the observation group underwent PCI after rhTNK-tPA thrombolytic therapy.The incidence of postoperative complications,cardiovascular blood flow status and coagulation function were compared between the two groups.Results There was no significant difference in the incidence of postoperative complications between the two groups(P>0.05).There was no significant difference in the blood flow grading of myocardial infarction thrombolysis test between the two groups before operation(P>0.05);after operation,the observation group had grade 2 as 2.27%(1/44)and grade 3 as 97.73%(43/44),which were better than 27.50%(11/40)and 72.50%(29/40)in the control group,and the difference was statistically significant(Z=10.889,P<0.05).Before operation,there was no significant differ⁃ence in coagulation function between the two groups(P>0.05),after operation,the prothrombin time,thrombin time and partial activated thrombin time in the observation group were longer than those in the control group,and the fi⁃brinogen was lower than that in the control group,the differences were statistically significant(all P<0.05).Conclu⁃sion Thrombolytic therapy with rhTNK-tPA does not increase complications after PCI in STEMI patients,and can im⁃prove cardiovascular blood flow status and coagulation function.

关 键 词：重组人TNK组织型纤溶酶原激活剂 溶栓 ST段抬高型心肌梗死 经皮冠状动脉介入 并发症 心血管血流 

分 类 号：R542.2[医药卫生—心血管疾病]