临床误诊误治2026，Vol.39Issue(1)：24-29,6.DOI:10.3969/j.issn.1002-3429.2026.01.005
尿激酶原联合尼可地尔在老年急性ST段抬高型心肌梗死患者急诊PCI术中的应用价值
Application value of Prourokinase combined with Nicorandil during emergency PCI for elderly patients with acute STEMI
摘要
Abstract
Objective To investigate the application value of Prourokinase combined with Nicorandil in emergency percutaneous coronary intervention(PCI)for elderly patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A total of 126 elderly patients with acute STEMI who underwent emergency PCI from December 2020 to December 2023 were selected as the research subjects for retrospective analysis.The patients were divided into two groups based on whether Prourokinase treatment was performed during PCI.The control group was treated with Nicorandil(n=82),and the research group was supplemented with Prourokinase on this basis(n=44).The myocardial injury markers[creatine kinase(CK),cardiac troponin I(cTnI),myocardial creatine kinase isoenzyme(CK-MB)],cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end-systolic volume index(LVESVI),left ventricular end-diastolic volume index(LVEDVI)],and no-reflow/slow blood flow,as well as incidence of major adverse cardiovascular events(MACE)and adverse reactions were compared between the two groups.Results The incidence of no-reflow/slow blood flow during PCI in the research group was 18.19％(8/44),which was lower than that[35.36％(29/82)]in the control group(P＜0.05).At 1 week after the operation,the levels of CK,cTnI,CK-MB,LVESVI and LVEDVI in both groups decreased compared with those before the operation,which were lower in the research group than in the control group(P＜0.05).At 1 week after the operation,the LVEF levels in both groups increased compared with those before the operation,and the levels in the research group were higher than those in the control group(P＜0.05).Within 6 months after the operation,there was no significant difference in the incidence of MACE between the two groups(P＞0.05),No significant difference in the incidence of adverse reactions between the two groups from the initiation of medication to 7 d after surgery(P＞0.05).Conclusion Prourokinase combined with Nicorandil can effectively prevent the phenomenon of no-reflow/slow blood flow in elderly patients with acute STEMI during emergency PCI,effectively improve myocardial perfusion,enhance cardiac function,and has high safety.关键词
急性ST段抬高型心肌梗死/尿激酶原/经皮冠状动脉介入治疗/无复流/慢血流/心肌损伤/主要心血管不良事件Key words
acute ST-segment elevation myocardial infarction/Prourokinase/percutaneous coronary intervention/no-reflow/slow blood flow/myocardial injury/major adverse cardiovascular events引用本文复制引用
王玉新,崔晓林,金姿..尿激酶原联合尼可地尔在老年急性ST段抬高型心肌梗死患者急诊PCI术中的应用价值[J].临床误诊误治,2026,39(1):24-29,6.基金项目
2021年度山东省医药卫生科技发展计划项目(202103100816) （202103100816）
