注射用重组人尿激酶原治疗急性ST段抬高型心肌梗死的临床研究

陈光影+李康玲+谭健明

【摘要】 目的：研究注射用重组人尿激酶原治疗急性ST段抬高型心肌梗死（STEMI）的临床效果。方法：选取60例STEMI患者，按照入院顺序将其分为对照组和观察组，每组30例。对照组给予尿激酶治疗，观察组给予注射用重组人尿激酶原治疗，比较两组患者的治疗效果。结果：观察组ST段回落≥50%率、ST段完全回落率、冠脉再通率及再灌注心律失常发生率均明显高于对照组，出血并发症发生率及心脏不良事件发生率均明显低于对照组，差异均有统计学意义（P<0.05）。结论：注射用重组人尿激酶原治疗STEMI效果确切，可有效促进心电图ST段的回落及血管再通，降低心脏不良事件发生率，且安全性高，值得推广应用。

【关键词】 注射用重组人尿激酶原； 急性ST段抬高型心肌梗死； 安全性

【Abstract】 Objective：To study the clinical effect of Recombinant Human Prourokinase for Injection in the treatment of acute ST segment elevation myocardial infarction（STEMI）.Method：60 patients with STEMI were selected and divided into control group and observation group according to the order of admission，30 cases in each group.The control group was treated with urokinase，and the observation group was treated with Recombinant Human Prourokinase for Injection，the therapeutic effects of the two groups were compared.Result：The ST segment fell 50% rate，ST segment or complete drop rate，incidence rate of coronary artery and reperfusion arrhythmia of the observation group were significantly higher than those in control group，the incidence of bleeding complications and the incidence of adverse cardiac events were significantly lower than those of the control group，the differences were statistically significant（P<0.05）.Conclusion：Recombinant Human Prourokinase for Injection treatment of STEMI effect is accurate，can effectively promote the ECG ST segment and vascular recanalization，reduce the incidence of adverse cardiac events，and high safety，worthy of promotion and application.

【Key words】 Reocmbinant Human Prourokinase for Injection； Acute ST-segment elevation myocardial infarction； Security

First-authors address：Jiangmen Wuyi Hospital of Traditional Chinese Medicine Enping Branch，Enping 529400，China

doi：10.3969/j.issn.1674-4985.2017.33.037

急性心肌梗死（STEMI）是冠状动脉急性、持续性缺血缺氧所引起的心肌坏死。临床上多有剧烈而持久的胸骨后疼痛，休息及硝酸酯类药物不能完全缓解，伴有血清心肌酶活性增高及进行性心电图变化，可并发心律失常、休克或心力衰竭，常可危及生命。本病在欧美最常见，美国每年约有150万人发生心肌梗死。中国近年来呈明显上升趋势，每年新发至少50万，现患者至少200万。STEMI是由冠状动脉硬化，斑块破裂出血和血栓形成导致的一种急危重症，起病急，进展快，其引发的恶性室性心律失常是导致患者死亡的主要原因[1-3]。早期采取有效的措施挽救缺血心肌是抢救成功的关键。有研究表明，再灌注治疗是急性心肌梗死治疗的关键，再灌注手段包括静脉溶栓、经皮冠狀动脉介入术和冠状动脉旁路术，对于符合溶栓治疗指征的患者应及时行静脉溶栓治疗[4]，本院采用注射用重组人尿激酶原这一新型溶栓剂治疗STEMI，取得了优于尿激酶的临床效果，现报道如下。……