天津医药

天津医药 ›› 2020, Vol. 48 ›› Issue (6): 539-542.

• 临床研究 • 上一篇    下一篇

血栓抽吸联合重组人尿激酶原预处理对高血栓负荷 STEMI患者冠脉血流及心肌灌注的影响

张靖 1，舒民 2，姚明言 2，臧燕伟 2，朱晓娟 2，李瑞雪 2，贾辛未 1
  

  1. 1河北大学附属医院心血管内科（邮编071000）；2保定市第一中心医院内分泌科

  • 收稿日期:2019-08-29 修回日期:2020-03-08 出版日期:2020-06-15 发布日期:2020-06-15
  • 通讯作者: 张靖 E-mail:zhangjingmd@163.com

Effects of thrombus aspiration combined with intracoronary rhpro-UK preconditioning in primary PCI of STEMI patients with high thrombus burden

ZHANG Jing1, SHU Min2, YAO Ming-yan2, ZANG Yan-wei2, ZHU Xiao-juan2, LI Rui-xue2, JIA Xin-wei1 #br#   

  1. 1 Department of Cardiology, the Affiliated Hospital of Hebei University, Baoding 071000, China; 2 Department of
    Endocrinology, Baoding First Central Hospital
  • Received:2019-08-29 Revised:2020-03-08 Published:2020-06-15 Online:2020-06-15
  • Contact: JING ZHANG E-mail:zhangjingmd@163.com

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摘要： 摘要：目的 评价血栓抽吸联合冠脉内靶向给予重组人尿激酶原预处理对高血栓负荷急性心肌梗死患者直接 冠脉介入治疗中冠脉血流及心肌灌注的影响。方法 选取我院急性ST段抬高型心肌梗死存在冠脉高血栓负荷并且 行直接冠脉介入治疗的患者120例，采用随机数字表法将入选患者分为试验组和对照组，试验组60例采用血栓抽吸 联合重组人尿激酶原预处理，对照组60例采用单纯血栓抽吸。比较2组术中冠脉血流、心肌灌注、术后30 d主要不 良心血管事件及出血发生率。结果 试验组术后TIMI血流3级比例、术后心肌染色分级（MBG）3级比例、术后2 h ST段回落率高于对照组，术后校正TIMI计帧数（cTFC）和无复流（NRP）发生率低于对照组（P＜0.05或P＜0.01）。2 组术后30 d内主要不良心血管事件及出血发生率比较差异无统计学意义。结论 血栓抽吸联合冠脉内靶向应用重 组人尿激酶原预处理可以改善高血栓负荷急性ST段抬高型心肌梗死患者冠脉血流及心肌灌注，且不增加脑卒中、短 期主要不良心血管事件及出血发生率。

关键词: ST段抬高型心肌梗死, 经皮冠状动脉介入治疗, 血栓抽吸, 重组人尿激酶原, 高血栓负荷, 预处理

Abstract: Abstract: Objective To evaluate the effect of thrombus aspiration combined with intracoronary recombinant human pro-urokinase (rhpro-UK) preconditioning on coronary blood flow and myocardial perfusion in patients with ST-segment elevation myocardial infarction (STEMI) and high thrombus burden. Methods A total of 120 STEMI patients with high thrombus burden treated with primary PCI were collected in this study. Patients were randomly divided into two groups: thrombus aspiration combined with intracoronary rhpro-UK group (n=60) and thrombus aspiration control group (n=60). The coronary blood flow, myocardial perfusion, major adverse cardiovascular events and incidence of hemorrhage were compared between the two groups. Results TIMI blood flow grade, myocardial blush grade and ST segment fall rate (≥50%) were all higher in the thrombus aspiration combined with intracoronary rhpro-UK group than those in the control group.After PCI, incidence rates of cTFCand NRP were significantly diseased (P＜0.05). There were no significant differences in stroke, major adverse cardiovascular events and bleeding within 30 days after operation between the two groups (P＞0.05). Conclusion Thrombus aspiration combined with intracoronary rhpro-UK preconditioning can improve the coronary blood flow and myocardial perfusion in primary PCI of STEMI patients with high thrombus burden.

Key words: ST elevation myocardial infarction, percutaneous coronary intervention, thrombus aspiration, rhpro-UK,
high thrombus burden, preconditioning