Influence Of Intracoronary Administration Of Recombinant Human Prourokinase Combined With Nicorandil On The Efficacy And Prognosis Of Patients With Acute ST-segment Elevation Myocardial Infarction After Emergency PCI

Objective To investigate the effect and prognosis of intracoronary administration of recombinant human prourokinase combined with nicorandil on patients with acute ST-segment elevation myocardial infarction after emergency percutaneous coronary intervention.Methods From November 2019 to September 2020,120 ASTEMI patients undergoing emergency PCI in the Chest Pain Center of Changde First People’s Hospital were selected as the research objects,Divide into 4 groups according to random number table:Intracoronary administration of normal saline(n=30)、Recombinant human prourokinase group(n=29)、 Nicorandil group(n=30)、Recombinant human prourokinase combined with nicorandil group(n=31),The demographics,clinical characteristics,infarct size,myocardial reperfusion and cardiac function,major adverse cardiovascular events(MACE)within 1,3,6,and 12 months after surgery and the results of coronary angiography 1 year after surgery were compared among the four groups.Results The demographics,clinical characteristics,infarct size,and biochemical examinations were compared among the four groups,The difference was not statistically significant(P>0.05);Comparison of intraoperative intervention indicators among four groups of patients,The difference was not statistically significant(P>0.05);Comparison of reperfusion arrhythmia,cardiac function,bleeding,and postoperative complications among the four groups of patients,The difference was not statistically significant(P>0.05);The prourokinase combined with nicorandil group had significantly higher postoperative TIMI grade 3,ST segment fallback rate within 2hours and CK-MB peak advance time than the other three groups,The incidence of no-reflow and slow blood flow,The differences were statistically significant(P<0.05).The incidence of MACE events within 1 month in the combined group was lower than that in the other three groups,and compared with the normal saline and nicorandil group,the difference was statistically significant(P<0.05),and compared with the prourokinase group,the difference was not statistically significant(P>0.05);Incidence of MACE events within 3,6,and 12 months after surgery,The combination group was lower than the normal saline group,The differences were statistically significant(P<0.05).The combined group can reduce the risk of MACE events in the short term(P<0.05).There was no significant difference in the comparison of coronary angiography among the four groups after 1 year.(P>0.05).Conclusions Coronary injection of recombinant human prourokinase and nicorandil can improve blood perfusion of infarcted vessels in patients with ASTEMI after emergency PCI,and can reduce the incidence of MACE events in the short term,but the risk of bleeding does not increase.