经靶向灌注导管冠状动脉内尿激酶原溶栓治疗STEMI的效果及预后观察

刘志远; 张金盈; 刘江波; 赵晓宁; 刘飞; 李纲

doi:10.13201/j.issn.1001-1439.2019.04.012

经靶向灌注导管冠状动脉内尿激酶原溶栓治疗STEMI的效果及预后观察

- 1. 郑州大学附属南阳医院(南阳市中心医院)心血管内科(河南南阳, 473009);
- 2. 郑州大学第一附属医院心内科河南郑州 450001
基金项目:
国家自然科学基金项目（No：81570274）

详细信息

通讯作者: 张金盈,E-mail:jyzhang@zzu.edu.cn

中图分类号: R542.2

收稿日期: 2018-11-15

Effects and prognosis of intracoronary urokinase thrombolysis through targeted perfusion catheter in the treatment of STEMI

- 1. Department of Cardiology, Nanyang Hospital Affiliated Hospital of Zhengzhou University, Nanyang, Henan, 473009, China;
- 2. Department of Cardiology, The First Affiliated Hospital of Zhengzhou University

More Information

Corresponding author: ZHANG Jinying, E-mail: jyzhang@zzu.edu.cn

Received Date: 15 November 2018

摘要

摘要: 目的：分析经靶向灌注导管冠状动脉（冠脉）内尿激酶原溶栓治疗ST段抬高型心肌梗死（STEMI）的效果及其对预后的影响。方法：回顾性分析我院接受尿激酶原靶向灌注导管冠脉内溶栓（观察组）及接受替罗非班靶向灌注导管冠脉内溶栓（对照组）行经皮冠脉介入治疗（PCI）的STEMI患者各61例临床资料。记录两组PCI术后梗死相关血管冠脉血流（TIMI）3级血流获得率及术后1周心肌微循环血流灌注情况[心肌灌注定量分析时间常数（k）]差异，并记录两组术后3个月时心功能指标[左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）、左心室射血分数（LVEF）]、不良心脑血管事件及出血事件等近期预后情况差异。结果：观察组术后TIMI 3级血流获得率明显高于对照组（P<0.05）。术后1周时，观察组基础态及负荷态心肌微循环血流灌注k值均较对照组高（P<0.05）。术后3个月时，观察组术后LVEDD、LVESD水平均较对照组低（P<0.05），且LVEF水平高于对照组（P<0.05）；而两组不良心脑血管事件及出血事件发生情况比较，差异均无统计学意义（P>0.05）。结论：经靶向灌注导管冠脉内尿激酶原溶栓可提高STEMI患者PCI治疗效果，且具有一定安全性，临床使用价值较高。
- ST段抬高型心肌梗死 /
- 经靶向灌注导管冠脉内溶栓 /
- 尿激酶原 /
- 冠状动脉介入治疗
Abstract: Objective: To analyze the effects of intracoronary urokinase thrombolysis through targeted perfusion catheter in the treatment of ST-segment elevation myocardial infarction (STEMI) and its influence on prognosis.Method: Clinical data of each 61 patients with STEMI who were treated with percutaneous coronary intervention (PCI) in our hospital and given intracoronary urokinase thrombolysis through targeted perfusion catheter (observation group) or intracoronary tirofiban thrombolysis through targeted perfusion catheter (control group) were retrospectively analyzed.The grade 3 blood flow acquisition rate of thrombolysis in myocardial infarction (TIMI) after PCI and myocardial microcirculation blood perfusion at 1 w after operation[myocardial perfusion quantitative analysis time constant (k)] were recorded in the two group.Cardiac function indicators at 3 months after operation[left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricular ejection fraction (LVEF)], adverse cardiovascular events and bleeding events and other recent prognosis were recorded in the two groups.Result: The TIMI grade 3 blood flow acquisition rate was significantly higher in observation group than that in control group (P<0.05).At 1 w after operation, the k values of myocardial microcirculation perfusion in the baseline and load in observation group were higher than those in control group (P<0.05).At 3 months after operation, the levels of LVEDD and LVESD in observation group were lower than those in control group (P<0.05) while the LVEF level was higher than that in control group (P<0.05).There were no significant differences in the occurrence of adverse cardiovascular events and bleeding events between the two groups (P>0.05).Conclusion: Intracoronary urokinase thrombolysis trough targeted perfusion catheter can improve the treatment effects of PCI in patients with STEMI, and it has certain safety and high clinical application value.
- ST-segment elevation myocardial infarction /
- Intracoronary thrombolysis through targeted perfusion catheter /
- Urokinase /
- PCI

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