| Objectives To investigate the efficacy and safety of low-dose rh-proUK in the treatment of low-thrombogenic burden of ST-segment elevation myocardial infarction(STEMI)patients who accept percutaneous coronary intervention(PCI).Methods we chose 68 patients who were diagnosed with STEMI and their vessls had a low thrombus load in Tangshan gongren Hospital,from January 2018 to August 2019.Patients who were selected for this trial were divided into 2 groups randomly.The test group that included 35 patients consisted of conventional PCI after intracoronary administration of 10 mg of rh-proUK,and the another group,including 35 patients,consisted coventional PCI after intracoronary administration of 10 mg of saline.Aspirin 300 mg and ticagrelor 180 mg were routinely administered before emergency PCI.Compare general data of the two groups,TIMI blood flow,CTFC,TMPG,STR,CK,CK-MB,the peak of cTnI,LVEF and LVED in 1 day and 1month after surgery,bleeding event in hospital and MACE during hospital and discharge for 6 months.Results 1 There were no differences in basic clinical data of the two groups,including age,BMI,heart rate,gender,hemoglobin,platelet,creatinine,hypertension,diabetes,history of coronary heart disease,history of cerebrovascular disease,smoking,drinking,etc.2 There are no differences in Post-PCI Situation of the two groups,including the diseased vessels(LAD,LCX,RCA),Killip classification,time from symptom to balloon dilation,and average stent number.3 The number of patients with TIMI blood flow level 3 in the experimental group was 31,accouting for 93.93%,and the number of patients with TIMI blood flow level 3 in another group was 32,accounting for 91.43%.The P was 0.95.The CTFC in the experimental group was 25.23±2.78,another grouo was27.58±4.46.P value is 0.01,and statistical difference existed.There are 31 patients with TMPG 3 in the experimental group,accounting for 93.93%,and 26 patients in another group,accouting for 74.29%.There was significant differences with CTFC because P was 0.03.4 The CK of the experimental group was 1220.89 ± 700.92,and the other group was 1643.36 ± 867.46.There was significant differences with CK because P was 0.03.The CK-MB peak in the test group was 150.71 ± 40.23 and in the other group was 170.23 ± 51.05.There was significant differences with CK-MB because P was 0.03.The TnI in experimental group was 6.01 ± 2.44,and the other group was 7.54 ± 2.76.There was significant differences with TnI because P was less than 0.05.The number of patients with STR after 2 hours was 29,accounting for 87.88%,and 23 patients in another group,accouting for 65.71%.P value was 0.03,and the difference of the two groups existed.5 The LVED of the experimental group and the control group at 1 day after operation were 51.82 ± 5.67 and 53.54 ± 4.32 mm,respectively.There was no significant differences with LVED at 1day in the two groups because the P was 0.31.The LVED of the experimental group and the control group at 1 month after operation were 50.61 ± 4.01 and 53.69 ± 6.41,respectively.There was significant differences with LVED at 1 month in the two groups because the P was 0.02.The LVEF of the experimental group and the control group at 1 day after operation were 53.43 ± 5.31 and 52.18 ± 4.98,respectively.There was no significant differences with LVEF at 1 day in the two groups because the P was 0.32.The LVEF of the two groups at 1 month after operation were 58.97 ± 5.56 and 56.11 ± 7.19.There was significant differences with LVEF at 1month in the two groups because the P was 0.03.6 The comparison of bleeding event in two groups: in experimental group,major bleeding events,minor bleeding events and insignificant bleeding events are 0,2 and 1 respectively.And these numbers added up to 3.In another group,major bleeding events,minor bleeding events and insignificant bleeding events are 0,1 and 1 respectively.And these numbers added up to 2.There was no difference about bleeding events in the two groups and the P value was 0.95.Comparison of MACE in two groups,in experimental group,the number of angina recurrence,myocardial reinfarction,cardiac death,revascularization,heart failure was 4,0,0,0,0,respectively.And these numbers added up to 4.In another group,the number of angina recurrence,myocardial reinfarction,cardiac death,revascularization,heart failure was 5,0,0,0,1,respectively.And the total was 6.There was no statistical difference about MACE in the two groups because that P was 0.81(P>0.05).Conclusions Intracoronary low-dose rh-proUK combined with PCI in patients with ST-segment elevation myocardial infarction with low thrombus load: 1 to increase myocardial perfusion level,reduce myocardial infarction area,and improve LVEF.2 The medicine is safe,and it does not gain the incidence of bleeding events and MACE.Figure0;Table6;Reference 133... |
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