Clinical Study Of Recombinant Human Prourokinase In The Treatment Of Acute ST-Segment Elevation Myocardial Infarction

Objective: To evaluate the efficacy and safety of intracoronary thrombolysis with recombinant human prourokinase during emergency percutaneous coronary intervention(PCI)in patients with acute ST segment elevation myocardial infarction(STEMI).Methods: 126 patients with acute myocardial infarction who underwent primary PCI were retrospectively analyzed,including 61 patients in the experimental group.After the discovery of the criminal’s blood vessels by coronary angiography,20 mg of recombinant human urokinase was administered in the coronary arteries,and an appropriate amount of contrast agent was injected again 10 minutes later to observe the coronary blood flow,and appropriate stent implantation was selected according to the pathological conditions of the coronary arteries.In the control group,65 patients were directly selected for stent implantation according to the coronary artery lesions after coronary angiography was found.The recovery rate of ST segment,the peak value of Tn I and CK-MB,the changes of cardiac function at 1 day and 1 month after operation,the content of NTpro BNP at 1 day after operation,bleeding events during hospitalization,major adverse cardiovascular events(MACEs)and MACEs 1 month after operation were compared and observed between the two groups.Results: There was no significant difference in baseline demographic,clinical and angiographic features between the two groups(P > 0.05).The falling rate of ST-segment in the experimental group was significantly higher than that in the control group(P < 0.05).The peak levels of serum CK-MB and Tn I in the experimental group were significantly lower than those in the control group(P < 0.05).One month after operation,the levels of Left ventricular ejection fractions(LVEF)and Left ventricular end-diastolic dimension(LVEDd)in the experimental group were significantly better than those in the control group(P < 0.05).There was no significant difference in LVEF and LVEDd between the two groups on the first day after operation(P(29)0.05).There was no significant difference in the incidence of bleeding events and MACEs during hospitalization and the incidence of MACEs one month and six month after operation between the two groups.Conclusion: intracoronary administration of prourokinase via balloon catheter during direct PCI can effectively improve myocardial perfusion and short-term cardiac function in patients with STEMI without increasing the risk of bleeding.