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武汉市第三医院急诊科 湖北 武汉 430060
Received:21 November 2023,
Published:25 June 2025
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余平,王瑛.半量尿激酶原溶栓联合急诊冠脉介入治疗对ST段抬高型心肌梗死患者心肌微循环灌注水平的影响[J].武汉大学学报(医学版),2025,46(06):754-758.
YU Ping,WANG Ying.Effect of half⁃dose prourokinase thrombolysis combined with emergency coronary intervention on the level of myocardial microcirculation perfusion in patients with ST‑segment elevation myocardial infarction[J].Medical Journal of Wuhan University,2025,46(06):754-758.
余平,王瑛.半量尿激酶原溶栓联合急诊冠脉介入治疗对ST段抬高型心肌梗死患者心肌微循环灌注水平的影响[J].武汉大学学报(医学版),2025,46(06):754-758. DOI: 10.14188/j.1671-8852.2023.0627.
YU Ping,WANG Ying.Effect of half⁃dose prourokinase thrombolysis combined with emergency coronary intervention on the level of myocardial microcirculation perfusion in patients with ST‑segment elevation myocardial infarction[J].Medical Journal of Wuhan University,2025,46(06):754-758. DOI: 10.14188/j.1671-8852.2023.0627.
目的
2
探究半量尿激酶原溶栓联合急诊冠脉介入治疗对ST段抬高型心肌梗死(STEMI)患者心肌微循环灌注水平的影响。
方法
2
将2020年8月—2022年8月于武汉市第三医院就诊的60例STEMI患者随机分为两组。对照组30例行急诊冠脉介入术,研究组30例在急诊冠脉介入术前予以半量尿激酶原溶栓治疗。比较两组手术前后的心肌微循环灌注水平、心肌损伤相关指标水平;评价两组手术后6个月内的不良心血管事件的发生情况,比较两组术前、术后3个月、6个月的日常生活能力。
结果
2
术后研究组的心肌梗死溶栓试验(TIMI)血流分级及TIMI心肌灌注分级(TMPG)改善效果优于对照组(
P
<
0.05);术后24 h研究组的超敏心肌肌钙蛋白I(hs‑cTnI)、B型利钠肽(BNP)、N‑末端B型利钠肽原(NT‑proBNP)水平低于对照组(
P
<
0.05);术后6个月,研究组的不良心血管事件发生率低于对照组(
P
<
0.05);术后3个月、6个月,研究组的Barthel指数评定量表(BI)评分较对照组升高(
P
<
0.05)。
结论
2
在行急诊冠脉介入术前应用半量尿激酶原溶栓治疗可有效改善STEMI患者的心肌微循环灌注水平及心肌损伤标记物水平,减少术后不良心血管事件,提高患者的日常生活能力。
Objective
2
To investigate the effect of half⁃dose prourokinase thrombolysis combined with emergency coronary intervention on the level of myocardial microcirculation perfusion in patients with ST‑segment elevation myocardial infarction (STEMI).
Methods
2
Sixty patients with STEMI treated in Wuhan Third Hospital from August 2020 to August 2022 were randomly divided into two groups. Thirty cases in the control group were treated with emergency coronary intervention
and another 30 cases in the study group were treated with half the dose of prourokinase before emergency coronary intervention. The myocardial microcirculation perfusion levels and myocardial injury‑related index levels were compared before and after operation
the occurrence of adverse cardiovascular events within 6 months after operation was evaluated
and the daily living ability between the two groups before operation
3 months
and 6 months after operation was compared.
Results
2
The improvement of thrombolysis in myocardial infarction (TIMI) blood flow grade and TIMI myocardial perfusion grading (TMPG) in the study group was better than that in the control group (
P
<
0.05). The levels of hs‑cTnI
BNP
and NT‑proBNP in the study group were lower than those in the control group 24 h after operation (
P
<
0.05). The incidence of adverse cardiovascular events in the study group was lower than that in the control group at 6 months after operation (
P
<
0.05). At 3 and 6 months after operation
the scores of Barthel index (BI) in study group were higher than those in control group (
P
<
0.05).
Conclusion
2
Preoperative thrombolytic therapy with a half dose of prourokinase can effectively improve myocardial microcirculation perfusion and myocardial injury markers in patients with STEMI
reduce postoperative adverse cardiovascular events
and improve patients' daily living ability.
SHAH T , KAPADIA S , LANSKY A J , et al . ST‑segment elevation myocardial infarction: Sex differences in incidence, etiology, treatment, and outcomes [J ] . Curr Cardiol Rep , 2022 , 24 ( 5 ): 529 ‑ 540 .
GRINES C L , MEHTA S . ST‑segment elevation myocardial infarction management: Great strides but still room for improvement [J ] . Eur Heart J , 2021 , 42 ( 44 ): 4550 ‑ 4552 .
马文颖 , 王成华 , 金海娇 , 等 . 急性ST段抬高型心肌梗死PPCI术中无复流现象的治疗进展 [J ] . 疑难病杂志 , 2023 , 22 ( 2 ): 220 ‑ 224 .
MA W Y , WANG C H , JIN H J , et al . Treatment progress of no‑reflow phenomenon during PPCI for acute ST‑segment elevation myocardial infarction [J ] . Chin J Difficult Complicat Cases , 2023 , 22 ( 2 ): 220 ‑ 224 .
KONIJNENBERG L S F , DAMMAN P , DUNCKER D J , et al . Pathophysiology and diagnosis of coronary microvascular dysfunction in ST‑elevation myocardial infarction [J ] . Cardiovasc Res , 2020 , 116 ( 4 ): 787 ‑ 805 .
BHATT D L , LOPES R D , HARRINGTON R A . Diagnosis and treatment of acute coronary syndromes: A review [J ] . JAMA , 2022 , 327 ( 7 ): 662 ‑ 675 .
JIANG C , GAO J , LUO D L , et al . Treatment of intravenous thrombolysis with half‑dose recombinant human prourokinase reduces the rate of tirofiban use during early routine catheterization period [J ] . Asian J Surg , 2022 , 45 ( 7 ): 1414 ‑ 1415 .
WANG X C , LIU H L , WU H B , et al . Safety and efficacy of intracoronary prourokinase administration in patients with high thrombus burden [J ] . Coron Artery Dis , 2020 , 31 ( 6 ): 493 ‑ 499 .
中华医学会心血管病学分会 , 中华心血管病杂志编辑委员会 . 急性ST段抬高型心肌梗死诊断和治疗指南(2019) [J ] . 中华心血管病杂志 , 2019 , 47 ( 10 ): 766 ‑ 783 .
Chinese Society of Cardiology , Editorial Board of Chinese Journal of Cardiology . 2019 Chinese Society of Cardiology (CSC) guidelines for the diagnosis and management of patients with ST⁃segment elevation myocardial infarction [J ] . Chin J Cardiol , 2019 , 47 ( 10 ): 766 ‑ 783 .
侯东哲 , 张颖 , 巫嘉陵 , 等 . 中文版Barthel指数的信度与效度研究 [J ] . 临床荟萃 , 2012 , 27 ( 3 ): 219 ‑ 221 .
HOU D Z , ZHANG Y , WU J L , et al . Study on reliability and validity of Chinese version of Barthel Index [J ] . Clin Focus , 2012 , 27 ( 3 ): 219 ‑ 221 .
KUMAR R , QAYYUM D , AHMED I , et al . Predilation ballooning in high thrombus laden STEMIs: An independent predictor of slow flow/No‑reflow in patients undergoing emergent percutaneous coronary revascularization [J ] . J Interv Cardiol , 2023 , 2023 : 4012361 .
刘金武 , 荣晶晶 , 刘征宇 , 等 . 血栓抽吸联合冠状动脉内溶栓对急性ST段抬高型心肌梗死患者直接经皮冠状动脉介入治疗术后冠状动脉微循环的影响 [J ] . 中国循环杂志 , 2022 , 37 ( 11 ): 1097 ‑ 1104 .
LIU J W , RONG J J , LIU Z Y , et al . Impact of thrombus aspiration combined with intracoronary thrombolysis on coronary microcirculation post primary percutaneous coronary intervention in patients with ST‑elevation myocardial infarction and high thrombus load [J ] . Chin Circ J , 2022 , 37 ( 11 ): 1097 ‑ 1104 .
赵景宏 , 乔彦 , 刘涛 , 等 . 低剂量重组人尿激酶原在急性ST段抬高型心肌梗死患者急诊经皮冠状动脉介入术中的应用效果研究 [J ] . 实用心脑肺血管病杂志 , 2021 , 29 ( 9 ): 77 ‑ 81 .
ZHAO J H , QIAO Y , LIU T , et al . Application effect of low‑dose recombinant human prourokinase in emergency percutaneous coronary intervention in patients with acute ST‑segment elevation myocardial infarction [J ] . Pract J Card Cereb Pneumal Vasc Dis , 2021 , 29 ( 9 ): 77 ‑ 81 .
周大鹏 , 刘春涛 , 陈贵艳 , 等 . 急性ST段抬高型心肌梗死经皮冠脉介入术前应用半量尿激酶原溶栓的疗效及安全性 [J ] . 内科急危重症杂志 , 2020 , 26 ( 4 ): 318 ‑ 320 .
ZHOU D P , LIU C T , CHEN G Y , et al . Efficacy and safety of half‑dose prourokinase thrombolysis before PCI in patients with acute ST‑segment elevation myocardial infarction [J ] . J Crit Care Intern Med , 2020 , 26 ( 4 ): 318 ‑ 320 .
李青 , 张英 , 任珊 . PCI治疗前冠脉内应用尿激酶原或替罗非班对STEMI患者心肌微循环再灌注的影响及安全性 [J ] . 临床和实验医学杂志 , 2023 , 22 ( 2 ): 123 ‑ 127 .
LI Q , ZHANG Y , REN S . Effects and safety of intracoronary prourokinase or tirofiban on myocardial microcirculation reperfusion in patients with STEMI before PCI [J ] . J Clin Exp Med , 2023 , 22 ( 2 ): 123 ‑ 127 .
李妮妮 , 周永峰 . 尿激酶原溶栓联合急诊经皮冠状动脉介入术对ST段抬高型心肌梗死患者的影响 [J ] . 实用临床医药杂志 , 2020 , 24 ( 18 ): 30 ‑ 33 .
LI N N , ZHOU Y F . Effect of urokinase thrombolysis combined with emergency percutaneous coronary intervention in patients with ST segment elevation myocardial infarction [J ] . J Clin Med Pract , 2020 , 24 ( 18 ): 30 ‑ 33 .
孙震 , 陈天宇 , 乐扬 , 等 . 重组人尿激酶原与替罗非班联用病灶内或冠脉内给药对ST段抬高型心肌梗死急诊经皮冠状动脉介入治疗患者术后心肌微循环、血管内皮功能和血清心肌酶指标的影响 [J ] . 药物评价研究 , 2023 , 46 ( 4 ): 835 ‑ 842 .
SUN Z , CHEN T Y , LE Y , et al . Effects of intracoronary administration and intrafocal administration of recombinant prourokinase combined with tirofiban on myocardial microcirculation, vascular endothelial function and serum levels of myocardial enzymes, IL‑18, MMP‑9 and MDA in patients [J ] . Drug Eval Res , 2023 , 46 ( 4 ): 835 ‑ 842 .
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