| 摘要: |
| ［摘要］ 目的 探讨尿激酶原联合替罗非班在急性ST段抬高型心肌梗死（ASTEMI）患者行急诊经皮冠状动脉介入治疗（PCI）中预防无复流/慢血流（NR/SF）的效果。方法 选取2017年9月1日至2020年6月30日张家界市人民医院心内科收治的90例ASTEMI患者的病历资料，均行急诊PCI-支架置入术，根据术中用药方案分为研究组（冠脉内尿激酶原联合替罗非班）和对照组（单纯使用替罗非班），每组45例。比较两组治疗前至出院前的TIMI血流分级、NR/SF发生率、心功能指标［左心室收缩末期直径（LVESD）、短轴缩短率（FS）、左心室舒张末期内径（LVEDD）及射血分数（EF）］水平、出血事件以及不良心脑血管事件的发生情况。结果 研究组术中NR/SF发生率显著低于对照组（4.44% vs 31.11%； χ2=10.946，P=0.001）。治疗后，研究组TIMI血流分级情况显著优于对照组（P<0.05）。两组LVEF、LVESD、EF、FS水平以及不良心脑及意外出血事件发生率比较差异无统计学意义（P>0.05）。结论 对于行急诊PCI-支架置入术的ASTEMI患者，尿激酶原联合替罗非班应用有助于改善血流灌注，降低NR/SF的发生率，不良反应少，安全性好。 |
| 关键词: 尿激酶原 替罗非班 急性ST段抬高型心肌梗死 经皮冠状动脉介入治疗 无复流/慢血流 |
| DOI：10.3969/j.issn.1674-3806.2021.06.08 |
| 分类号:R 540.4 |
| 基金项目:湖南省卫健委科研课题（编号：B2016206） |
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| The efficacy of prourokinase combined with tirofiban in prevention of no-reflow/slow-flow in patients with acute ST-segment elevation myocardial infarction during emergency PCI |
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CHEN Li-hua, SHEN Sheng-chun, XIANG Ming-jun
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School of Medicine, Jishou University, Hunan 416000, China
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| Abstract: |
| ［Abstract］ Objective To explore the efficacy of prourokinase combined with tirofiban in prevention of no-reflow/slow-flow(NR/SF) in acute ST-segment elevation myocardial infarction(ASTEMI) patients undergoing emergency percutaneous coronary intervention(PCI). Methods The medical records of 90 ASTEMI patients admitted to the Department of Cardiology, Zhangjiajie City People′s Hospital from September 1, 2017 to June 30, 2020 were selected. All the patients underwent emergency PCI-stent implantation. According to the intraoperative medication regimens, the patients were divided into the study group(receiving intracoronary prourokinase combined with tirofiban) and the control group(receiving tirofiban alone), with 45 cases in each group. The thrombolysis in myocardial infarction(TIMI) blood flow classification, NR/SF incidence, the levels of cardiac function indexes［including left ventricular end-systolic dimension(LVESD), fractional shortening(FS), left ventricular end-diastolic dimension(LVEDD) and ejection fractions(EF)］, the occurrence of bleeding events and adverse cardiovascular and cerebrovascular events were compared between the two groups during the period of time from preoperation until discharge. Results The incidence of NR/SF in the study group was significantly lower than that in the control group(4.44% vs 31.11%; χ2=10.946, P=0.001). After treatment, the TIMI blood flow classification of the study group was significantly better than that of the control group(P<0.05). There were no statistically significant differences in the levels of LVEF, LVESD, EF and FS, and the incidence rates of adverse cardiac and cerebral events and accidental hemorrhage between the two groups(P>0.05). Conclusion For ASTEMI patients undergoing emergency PCI-stent implantation, the application of prourokinase combined with tirofiban is helpful to improve blood perfusion and reduce the incidence of NR/SF, with less adverse reactions and good safety. |
| Key words: Prourokinase Tirofiban Acute ST-segment elevation myocardial infarction(ASTEMI) Percutaneous coronary intervention(PCI) No-reflow/slow-flow(NR/SF) |
