尿激酶原联合尼可地尔在老年急性ST段抬高型心肌梗死患者急诊PCI术中的应用价值OA
Application value of Prourokinase combined with Nicorandil during emergency PCI for elderly patients with acute STEMI
目的 探讨尿激酶原联合尼可地尔在老年急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)术中的应用价值.方法 选取2020年12月至2023年12月期间接受急诊PCI的126例老年急性STEMI患者作为研究对象,进行回顾性分析.根据PCI术中是否采用尿激酶原治疗分为两组,对照组采用尼可地尔治疗(n=82),研究组在此基础上联合尿激酶原治疗(n=44).比较两组心肌损伤标志物[肌酸激酶(CK)、肌钙蛋白I(cTnI)、心肌型肌酸激酶同工酶(CK-MB)]、心功能指标[左心室射血分数(LVEF)、左心室收缩末期容积指数(LVESVI)、左心室舒张末期容积指数(LVEDVI)]、无复流/慢血流发生率、主要心血管不良事件(MACE)及不良反应发生情况.结果 研究组PCI术中无复流/慢血流发生率为18.19％(8/44),低于对照组的35.36％(29/82,P＜0.05).手术后1周,两组CK、cTnI、CK-MB、LVESVI、LVEDVI水平均较手术前下降,且研究组低于对照组(P＜0.05).手术后1周,两组LVEF水平均较手术前上升,且研究组较对照组更高(P＜0.05).手术后6个月内,两组MACE发生率比较无统计学差异(P＞0.05).两组从用药开始至术后7 d不良反应发生率比较均无统计学差异(P＞0.05).结论 尿激酶原联合尼可地尔可有效预防老年急性STEMI患者急诊PCI术中无复流/慢血流的现象,有效改善心肌灌注,提高心功能,且安全性高.
Objective To investigate the application value of Prourokinase combined with Nicorandil in emergency percutaneous coronary intervention(PCI)for elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 126 elderly patients with acute STEMI who underwent emergency PCI from December 2020 to December 2023 were selected as the research subjects for retrospective analysis.The patients were divided into two groups based on whether Prourokinase treatment was performed during PCI.The control group was treated with Nicorandil(n=82),and the research group was supplemented with Prourokinase on this basis(n=44).The myocardial injury markers[creatine kinase(CK),cardiac troponin I(cTnI),myocardial creatine kinase isoenzyme(CK-MB)],cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end-systolic volume index(LVESVI),left ventricular end-diastolic volume index(LVEDVI)],and no-reflow/slow blood flow,as well as incidence of major adverse cardiovascular events(MACE)and adverse reactions were compared between the two groups.Results The incidence of no-reflow/slow blood flow during PCI in the research group was 18.19％(8/44),which was lower than that[35.36％(29/82)]in the control group(P＜0.05).At 1 week after the operation,the levels of CK,cTnI,CK-MB,LVESVI and LVEDVI in both groups decreased compared with those before the operation,which were lower in the research group than in the control group(P＜0.05).At 1 week after the operation,the LVEF levels in both groups increased compared with those before the operation,and the levels in the research group were higher than those in the control group(P＜0.05).Within 6 months after the operation,there was no significant difference in the incidence of MACE between the two groups(P＞0.05),No significant difference in the incidence of adverse reactions between the two groups from the initiation of medication to 7 d after surgery(P＞0.05).Conclusion Prourokinase combined with Nicorandil can effectively prevent the phenomenon of no-reflow/slow blood flow in elderly patients with acute STEMI during emergency PCI,effectively improve myocardial perfusion,enhance cardiac function,and has high safety.
王玉新;崔晓林;金姿
济南市第一人民医院心内一科,济南 250014济南市第一人民医院心内科,济南 250014济南市第一人民医院心内一科,济南 250014
急性ST段抬高型心肌梗死尿激酶原经皮冠状动脉介入治疗无复流慢血流心肌损伤主要心血管不良事件
acute ST-segment elevation myocardial infarctionProurokinasepercutaneous coronary interventionno-reflowslow blood flowmyocardial injurymajor adverse cardiovascular events
《临床误诊误治》 2026 (1)
24-29,6
2021年度山东省医药卫生科技发展计划项目(202103100816)
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