重组尿激酶原联合替罗非班在急性心肌梗死介入治疗中的作用

发布时间：2018-03-20 21:36

  本文选题：重组人尿激酶原　切入点：替罗非班　出处：《中国临床药理学杂志》2017年21期 　论文类型：期刊论文

【摘要】：目的观察冠状动脉内联合应用重组人尿激酶原(Pro-uk)及替罗非班对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入治疗(PCI)术后的冠状动脉血流、心肌受损程度及主要心脏不良事件(MACE)的影响。方法将本院98例进行PCI术的STEMI患者随机分为试验组48例,对照组50例。术前所有患者顿服阿司匹林肠溶片300 mg和替格瑞洛180 mg。对照组直接进行PCI治疗,试验组冠状动脉造影后,冠状动脉内注射重组人尿激酶原10 mg及替罗非班10μg·kg~(-1)。统计患者PCI术后校正心肌梗死溶栓(TIMI)帧数(CTFC)及心肌灌注分级(TMP)。监测手术前后心肌损伤标志物肌酸激酶同功酶(CK-MB)和肌钙蛋白Ⅰ(cTnⅠ)水平。记录PCI术后30 d的主要心脏不良事件。结果术后,试验组和对照组CTFC分别为21.97±5.21,30.56±4.85,差异有统计学意义(P0.05)。试验组和对照组心肌灌注分级2级以上的比例分别为75.00%,56.00%,差异有统计学意义(P0.05)。试验组术后24 h CK-MB、cTnⅠ分别为(29.24±8.87),(8.34±2.01)ng·mL~(-1),对照组分别为(36.93±9.45),(9.36±1.68)ng·mL~(-1),差异均有统计学意义(均P0.05)。试验组出现严重心力衰竭1例(2.08%);对照组出现严重心力衰竭8例(16.00%),恶性心律失常6例(12.00%),2组药物不良反应发生率,差异有统计学意义(P0.05)。结论冠状动脉内联合应用重组人尿激酶原及替罗非班可改善STEMI患者急诊PCI术后的心肌微循环灌注,减轻心肌受损程度,降低了主要心脏不良事件的发生率。
[Abstract]:Objective to observe the coronary blood flow in patients with acute St segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI) with recombinant human urokinase Pro-ukand and tirofiban. Methods 98 STEMI patients undergoing PCI in our hospital were randomly divided into trial group (n = 48) and control group (n = 48). 50 patients in the control group were given aspirin enteric-coated tablets 300mg and tigrilol 180mg before operation. The control group was treated directly with PCI, and the patients in the trial group were treated with coronary arteriography. Intracoronary injection of recombinant human urokinase 10 mg and tirofiban 10 渭 g 路kg ~ (-1). The myocardial infarction thrombolytic thrombolytic thrombolytic activity (TIMI) frame count and myocardial perfusion grading were measured after PCI. The myocardial injury marker, Creatine Kinase isoenzyme (CK-MBB), was monitored before and after operation. The main adverse cardiac events were recorded 30 days after PCI. The CTFC of the experimental group and the control group were 21.97 卤5.21 卤30.56 卤4.85 respectively, the difference was statistically significant (P 0.05). The ratio of myocardial perfusion grade 2 or more in the experimental group and the control group was 75.00 and 56.00, respectively. The difference was statistically significant (P 0.05). The CK-MBcTn 鈪，

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