發(fā)布時(shí)間：2018-03-20 21:36

  本文選題：重組人尿激酶原　切入點(diǎn)：替羅非班　出處：《中國(guó)臨床藥理學(xué)雜志》2017年21期 　論文類型：期刊論文

【摘要】：目的觀察冠狀動(dòng)脈內(nèi)聯(lián)合應(yīng)用重組人尿激酶原(Pro-uk)及替羅非班對(duì)急性ST段抬高型心肌梗死(STEMI)患者經(jīng)皮冠狀動(dòng)脈介入治療(PCI)術(shù)后的冠狀動(dòng)脈血流、心肌受損程度及主要心臟不良事件(MACE)的影響。方法將本院98例進(jìn)行PCI術(shù)的STEMI患者隨機(jī)分為試驗(yàn)組48例,對(duì)照組50例。術(shù)前所有患者頓服阿司匹林腸溶片300 mg和替格瑞洛180 mg。對(duì)照組直接進(jìn)行PCI治療,試驗(yàn)組冠狀動(dòng)脈造影后,冠狀動(dòng)脈內(nèi)注射重組人尿激酶原10 mg及替羅非班10μg·kg~(-1)。統(tǒng)計(jì)患者PCI術(shù)后校正心肌梗死溶栓(TIMI)幀數(shù)(CTFC)及心肌灌注分級(jí)(TMP)。監(jiān)測(cè)手術(shù)前后心肌損傷標(biāo)志物肌酸激酶同功酶(CK-MB)和肌鈣蛋白Ⅰ(cTnⅠ)水平。記錄PCI術(shù)后30 d的主要心臟不良事件。結(jié)果術(shù)后,試驗(yàn)組和對(duì)照組CTFC分別為21.97±5.21,30.56±4.85,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。試驗(yàn)組和對(duì)照組心肌灌注分級(jí)2級(jí)以上的比例分別為75.00%,56.00%,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。試驗(yàn)組術(shù)后24 h CK-MB、cTnⅠ分別為(29.24±8.87),(8.34±2.01)ng·mL~(-1),對(duì)照組分別為(36.93±9.45),(9.36±1.68)ng·mL~(-1),差異均有統(tǒng)計(jì)學(xué)意義(均P0.05)。試驗(yàn)組出現(xiàn)嚴(yán)重心力衰竭1例(2.08%);對(duì)照組出現(xiàn)嚴(yán)重心力衰竭8例(16.00%),惡性心律失常6例(12.00%),2組藥物不良反應(yīng)發(fā)生率,差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論冠狀動(dòng)脈內(nèi)聯(lián)合應(yīng)用重組人尿激酶原及替羅非班可改善STEMI患者急診PCI術(shù)后的心肌微循環(huán)灌注,減輕心肌受損程度,降低了主要心臟不良事件的發(fā)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 鹵5.21 鹵30.56 鹵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，

本文編號(hào)：1640882