Comparison Of The Efficacy Of Thrombolysis Combined With Anticoagulation Therapy And Simple Thrombolysis On Transfer For PCI In STEMI Patients

Objective:To observe the clinical efficacy of thrombolysis combined with anticoagulation therapy and simple thrombolysis on transfer for PCI in STEMI patients,and to improve the clinical awareness of the diease,and to provide more safe,reliable and effective prehospital treatment on patients with STEMI.Method:From April 2018 to November 2019,51 ?eligible ?patients ?with SETMI??were enrolled,patients undergoing pre-hospital thrombolysis and transfer for PCI treatment were divided into anticoagulant group(24 cases)and non-anticoagulant group(27 cases)according to whether or not anticoagulant treatment was performed.Age,sex,body mass index,height,weight,smoking history,drinking history,diabetes history,family history of coronary heart disease,lipid index,serum creatinine and other related clinical data were collected.The rates of coronary artery regeneration and the EF and FS values of cardiac ultrasound were compared between the two groups.On the same time,observed the adverse reactions in the hospital.The anticoagulation group was divided into three groups according to the APTT value: the first ?group(10 patients with APTT value less than 50 seconds),the second group(4 patients with APTT value 50-70 seconds),and the third group(10 patients with APTT value more than 70 seconds).The coronary artery regeneration rate and EF,FS values were compared among the three groups.Results:1.There were not significantly different on age,sex,body mass index,height,weight,smoking history,drinking history,diabetes history,family history of coronary heart disease,lipid index,family history of hypertension,coronary heart disease,TG,TC,HDL-C,LDL-C,AST,ALT,Scr and other? ?related ?clinical?data between the anticoagulant group and the non-anticoagulant group(P>0.05).Between the first group and the second group and the third group had the same result(P>0.05).2.There were 20 cases of thrombolytic recanalization in the anticoagulant group and 14 cases in the non-anticoagulant group.?The recanalization rates were 83.33% and 51.85%,the differences were statistically significant(P<0.05).There were statistically significant differences in EF and FS between the anticoagulant group and the non-anticoagulant group(P<0.05).3.There were 7 cases of thrombolytic recanalization in the first group and 4 cases in the second group and 9 cases in the third group,there were not significant differences(P> 0.05).EF in the first group,the second group and the third group showed significant differences(P<0.05),while FS showed no significant differences(P>0.05).There was a significant difference in EF between the first group and the second group(P<0.05).4.In the non-anticoagulant group,there was one case of gingival bleeding(3.57%)and one case of subcutaneous bleeding(3.57%).In the anticoagulation group,there were two cases of gingival bleeding(8.33%),one case of nosebleed(4.17%),and one case of thrombocytopenia(4.17%).There were not significant differences(P> 0.05).Conclusion:1.For STEMI patients with transfer PCI,thrombolysis combined with anticoagulation therapy had a better effect on thrombolytic recanalization rate than simple thrombolysis.2.For STEMI patients with transfer PCI,thrombolysis combined with anticoagulation therapy had a better protective effect on cardiac function than simple thrombolysis.3.In the anticoagulation group,APTT at 50-70 seconds had a better protective effect on cardiac function.