摘要
Abstract
Objective To investigate the therapeutic effect of recombinant human prourokinase(rhPro-UK)combined with tirofiban in elderly patients with acute ST-segment elevation myocardial infarction(STE-MI)after PCI and the influence on myocardial indexes and inflammatory indexes.Methods A total of 112 elderly patients with STEMI admitted to Haikou Third People's Hospital from January 2021 to December 2022 were selected as the research objects,and they were divided into observation group and control group ac-cording to the random number table method,with 56 cases in each group.The thrombolysis in myocardial in-farction(TIMI)flow grade,corrected TIMI flow meter frame number(cTFC),TIMI myocardial perfusion grade(TMPG)and ST segment resolution rate(STR)were compared between the two groups before and im-mediately after PCI.The levels of serum N-terminal pro-brain natriuretic peptide(NT-proBNP),left ventricu-lar end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)and left ventricular ejec-tion fraction(LVEF)were compared between the two groups before and 1 month after PCI.The levels of ser-um interleukin(IL)-1β,IL-6 and C-reactive protein(CRP)were compared between the two groups before and 1 week after PCI.Bleeding events during operation and within 24 hours after operation,and major adverse car-diovascular events(MACE)during hospitalization and within 3 months after PCI were recorded and compared between the two groups.Results There were no significant difference in preoperative TIMI flow grade,TMPG,and cTFC between the two groups(P＞0.05).The postoperative TIMI blood flow grade,TMPG grade and STR＞50％in the observation group were significantly higher than those in the control group,while the postoperative cTFC in the observation group was lower than that in the control group,and the differences were statistically significant(P＜0.05).The TIMI blood flow grade and TMPG in the observation group and the control group were significantly higher than those in the control group,and the cTFC was sig-nificantly lower than that in the control group,and the differences were statistically significant(P＜0.05).One month after operation,NT-proBNP,LVEDD and LVESD in the observation group were significantly low-er than those in the control group,LVEF was higher than that in the control group,and the differences were statistically significant(P＜0.05).The levels of NT-proBNP,LVEDD and LVESD in the observation group and the control group were significantly lower than those before operation,and the LVEF was significantly higher at 1 month after operation(P＜0.05).There was no significant difference in incidence of total bleeding events between the observation group and the control group(X2=0.101,P=0.751).There was no significant difference in the incidence of total MACE between the observation group and the control group within 3 months after operation(X2=1.734,P=0.188).The levels of IL-1β,IL-6 and CRP in the observation group were significantly lower than those in the control group at 1 week after operation,and the differences were sta-tistically significant(P＜0.05).The levels of IL-1β,IL-6 and CRP in the observation group and the control group were significantly lower than those before operation,and the differences were statistically significant(P＜0.05).Conclusion Intracoronary application of rhPro-UK combined with tirofiban during PCI in elderly patients with STEMI can effectively improve myocardial perfusion and cardiac function,reduce inflammatory response,and does not increase the risk of bleeding and the incidence of MACE.关键词
急性ST段抬高型心肌梗死/老年人/重组人尿激酶原/替罗非班/经皮冠状动脉介入Key words
acute ST-segment elevation myocardial infarction/the elderly/recombinant human prou-rokinase/tirofiban/percutaneous coronary intervention was performed分类
临床医学
