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

余平; 王瑛

doi:10.14188/j.1671-8852.2023.0627

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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

临床医学研究 | 更新时间：2026-11-05

- 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
- 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
- 武汉大学学报（医学版） 2025年46卷第6期页码：754-758
- 作者机构：
  
  武汉市第三医院急诊科湖北武汉　430060
- 作者简介：
  
  余平，男，1980—，医学硕士，主治医师，主要从事急危重症的临床科研和教学研究，E‑mail：tjyuping@163.com
  王瑛，女，1978—，主治医师，主要从事急危重症的临床研究，E‑mail：32750725@qq.com
- 基金信息：
  
  武汉市临床医学科研项目(WX21B32)
- DOI：10.14188/j.1671-8852.2023.0627
  中图分类号： R541
- 收稿：2023-11-21，
  
  纸质出版：2025-06-25
- 稿件说明：
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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.

摘要

目的

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

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

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（

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（

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（

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（

0.05）。

结论

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。

Abstract

Objective

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

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

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 (

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 (

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 (

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 (

0.05).

Conclusion

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.

关键词

Keywords

references

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