冠状动脉内注射重组人尿激酶原在急诊经皮冠状动脉介入治疗中的效果分析  

Analysis of the clinical effect of intracoronary injection of recombinant human prourokinase on emergency percutaneous coronary intervention

作　　者：郑恒 甘受益[1] 付婧 李宾[1] ZHENG Heng;GAN Shouyi;FU Jing;LI Bin(Department of Cardiovascular Medicine,Xianning Central Hospital(First Affiliated Hospital of Hubei University of Science and Technology),Xianning 437100,Hubei Province,China;Department of Gynecology,Xianning Central Hospital(First Affiliated Hospital of Hubei University of Science and Technology),Xianning 437100,Hubei Province,China)

机构地区：[1]咸宁市中心医院(湖北科技学院附属第一医院)心血管内科,湖北咸宁437100 [2]咸宁市中心医院(湖北科技学院附属第一医院)妇科,湖北咸宁437100

出　　处：《药物流行病学杂志》2024年第11期1209-1218,共10页Chinese Journal of Pharmacoepidemiology

摘　　要：目的探讨注射用重组人尿激酶原冠状动脉内注射在急诊经皮冠状动脉介入术(PCI)的急性ST段抬高型心肌梗死(STEMI)患者中应用的临床价值。方法采用回顾性分析方法,收集2019年1—12月心内科行急诊PCI术的STEMI患者,按照术中患者在支架植入前经指引导管靶向注射药物的不同,分为替罗非班组(70例)与重组人尿激酶组(70例),比较2组患者TIMI血流分级、梗死相关动脉ST段回落值(STR)、血浆D-二聚体、左室射血分数(LVEF)及冠状动脉微循环功能障碍,记录2组患者一般资料及主要不良心血管事件(MACE)及出血情况等。结果与替罗非班组比较,重组人尿激酶原组患者TIMI血流水平、LVEF、血浆D-二聚体、STR≥70%患者比例均明显升高,而慢血流/无复流与MACE发生率明显降低,差异有统计学意义(P<0.05)。重组人尿激酶原组出血事件发生率有降低趋势,但2组差异无统计学意义(P>0.05)。结论经指引导管冠状动脉内注射重组人尿激酶原可显著改善STEMI患者的心肌血流灌注和预后,降低不良心血管事件,安全系数高,值得临床推广。Objective To investigate the clinical value of intracoronary injection of recombinant human prourokinase for injection in patients with acute ST-segment elevation myocardial infarction(STEMI)undergoing emergency percutaneous coronary intervention(PCI).Methods Retrospective analysis was used to collect STEMI patients who underwent emergency PCI in department of cardiology from January to December 2019.According to the targeted injection of drugs through a guided catheter by intraoperative patients before stent implantation,the patients were divided into a tirofiban group(70 cases)and a recombinant human urokinase group(70 cases).TIMI blood flow grade,ST segment fall value(STR)of infarct-related artery,plasma D-dimer,left ventricular ejection fraction(LVEF)and coronary microcirculation dysfunction were compared between the two groups.At the same time,the general information of the patients,major adverse cardiovascular events(MACE)and bleeding were recorded.Results Compared with the tirofiban group,the TIMI blood flow level,LVEF,plasma D-dimer,and the proportion of the patients with STR≥70%in the recombinant human prourokinase group were significantly increased,while the incidence of slow flow/no reflow and MACE were significantly reduced,and the differences between the two groups were statistically significant(P<0.05).The incidence of bleeding events in the recombinant human prourokinase group showed a downward trend,but there was no significant difference between the two groups(P>0.05).Conclusion Intracoronary injection of recombinant human prourokinase through the guiding catheter can significantly improve myocardial perfusion and prognosis in patients with STEMI.It also reduces adverse cardiovascular events and has a high safety margin,which is worth promoting in the clinic.

关 键 词：重组人尿激酶原 急性ST段抬高型心肌梗死 急诊经皮冠状动脉介入术 临床效果 

分 类 号：R542.22[医药卫生—心血管疾病]