The Impact Of Intracoronary Injection Of Recombinant Human Prourokinase Thrombolysis For Improving Myocardial Perfusion Of Patients With Acute Myocardial Infarction

Objective:To investigate the impact of intracoronary injection of recombinant human prourokinase thrombolysis for improving myocardial perfusion of patients with acute myocardial infarction.Methods:Patients with acute myocardial infarction admitted to Affiliated Nanhua Hospital from October 2016 to April 2018 and treated with primary PCI in the catheterization room of department of cardiology were included in this study.All selected patients were in accordance with the 2018 /AHA(American Heart Association)ACC(American Heart Association)guidelines for diagnostic criteria.120 patients who met the inclusion criteria were randomly assigned to the experimental group and the control group.Sixty patients in the experimental group were to receive 10 ml of(10mg)rh-proUK via suction catheter at the proximal end of coronary occlusive.Sixty patients in the control group were to receive 10 ml of heparin solution via suction catheter at the proximal end of coronary occlusive.All selected patients were given aspirin loading 300 mg,clopidogrel 300 mg oral administration before operation.A maintaining dose of aspirin 100 mg daily(the long-term use)and clopidogrel 75 mg daily(at least one year)after operation.and low molecular weight heparin0.5-1mg/kg/12 h,by subcutaneous injection and continuouing 5-7 days.Other medications like angiotensin converting enzyme or inangiotensin receptor blocker,β-receptor blockers,nitrates,sedatives and statins were used in accordance with the current guidelines.Comparing the two groups of patients 0f(1)postoperative 24 hours of ST segment resolution(2)the level of creatine kinase-MB and Troponin before and after 3 days 0f surgery(3)TIMI flow grade and blood flow after surgery(4)bleedlicaing comptions after surgery(5)the incidence of major adverse cardiac events after 6 months of surgery.SPSS 22.0 software was used for statistical analysis of the obtained data.Results:1.Basic clinical characteristics of study population: In this study,120 patients were enrolled,60 patients in experimental group and 60 patients in control group,there was no significant difference in the clinical data between two groups(P>0.05).2.The TIMI flow grade and blood flow after surgery showed that compared with the control group,the blood flow of the experimental group was significantly improved,there was statistically significant(P<0.05).3.The level of CK-MB and cTnI before and after 3 days 0f surgery of the experimental group were lower than control group,there was statistically significant(P<0.05).The postoperative 24 hours of ST segment resolution of the experimental group was higher than the control group,and there was statistically significant(P<0.05).4.Comparison of bleedlicaing comptions: there was no significant difference in bleedlicaing comptions after operation between the experimental group and the control group(P>0.05).5.Comparison of the occurrence rate of major adverse cardiac events at one month and six months after surgery : the incidence of MACE of the experimental group was lower than the control group,there was statistically significant(P<0.05).Conclusion:Intracoronary injection of recombinant human prourokinase thrombolysis can improve slow coronary flow or no coronary reflow phenomenon and the myocardial perfusion during PCI in patients with acute myocardial infarction without increasing the risk of bleeding,the occurrence rate of MACE after 6 months of surgery are reduced.