中国医学工程2025，Vol.33Issue(4)：49-53,5.DOI:10.19338/j.issn.1672-2019.2025.04.010
肝素预处理对急性ST段抬高型心肌梗死冠脉血流动力学及预后的影响研究
Effect of heparin pretreatment on coronary hemodynamics and prognosis in acute ST-segment elevation myocardial infarction
摘要
Abstract
[Objective]To observe the effects of heparin pretreatment on coronary hemodynamics and prognosis in ST-segment elevation myocardial infarction(STEMI)patients.[Methods]This was a prospective study,and 109 STEMI patients admitted to the Second Affiliated Hospital of Henan University of Science and Technology from January 2022 to October 2023 were selected.They were divided into the percutaneous coronary intervention(PCI)group(54 cases)and the heparin group(55 cases)using computer random grouping method.The PCI group received emergency PCI treatment directly,while the heparin group received preoperative heparin pretreatment to assist emergency PCI.The coronary hemodynamic parameters,myocardial injury markers,coronary angiography results,cardiac function indicators,and prognosis of the two groups of patients were compared.[Results]Under different treatment regimens,the systolic peak velocity(SPV),diastolic peak velocity(DPV),and coronary flow velocity reserve(CFVR)of the heparin group were 15.25±3.31 cm/s,30.29±5.33 cm/s,and 3.43±0.36,higher than the PCI group(13.39±3.25 cm/s,27.66±5.41 cm/s,and 2.65±0.72)(P<0.05).The myoglobin(MYO),creatine kinase-myocardial band(CK-MB),and lactate dehydrogenase(LDH)of the heparin group were 61.35±10.26 μg/L,10.44±2.28 U/L,and 40.31±10.19 U/L,lower than those in the PCI group(66.29±10.44 μg/L,12.28±3.41 U/L,45.36±10.22 U/L)(P<0.05).The thrombolysis rate of the heparin group[90.91%(50/55)]was higher than that of the PCI group[59.26%(32/54)](P<0.05).The high thrombus burden rate and the incidence of slow/no reflow in myocardial blood flow of the heparin group were 5.45%(3/55)and 3.64%(2/55),lower than those of the PCI group[22.22%(12/54)and 18.52%(10/54)](P<0.05).The left ventricular ejection fraction(LVEF)of the heparin group(55.25%±10.36%)was higher than that of the PCI group(50.28%±10.32%),and the left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)were 115.41±20.45 mL and 55.32±10.49 mL,lower than the PCI group(130.33±20.55 mL and 60.29±10.62 mL)(P<0.05).The incidence of major adverse cardiovascular event(MACE)in the heparin group was 1.82%(1/55),lower than the PCI group 18.52%(10/54)(P<0.05).[Conclusion]Heparin pretreatment can improve coronary hemodynamics in STEMI,which has a positive significance in reducing myocardial injury after PCI,enhancing treatment efficacy,promoting cardiac function recovery,and reducing the risk of MACE.关键词
急性ST段抬高型心肌梗死/肝素预处理/经皮冠脉介入术/冠脉血流动力学/预后情况Key words
acute ST-segment elevation myocardial infarction/heparin pretreatment/percutaneous coronary intervention/coronary hemodynamics/prognostic situation分类
临床医学引用本文复制引用
谢爱娟,王阳阳..肝素预处理对急性ST段抬高型心肌梗死冠脉血流动力学及预后的影响研究[J].中国医学工程,2025,33(4):49-53,5.基金项目
河南省医学科技攻关项目(LHGJ2020021837) （LHGJ2020021837）
