摘要
目的 探讨冠状动脉内注射重组人尿激酶原联合沙库巴曲缬沙坦治疗急性ST段抬高型心肌梗死(STEMI)的效果,并分析其对患者心功能、血清硫脑苷脂、诱骗受体3(DcR3)水平的影响。方法 回顾性分析2022年1月至2023年7月河南省直第三人民医院101例STEMI患者的临床资料,根据治疗方法分为对照组(冠状动脉内注射重组人尿激酶原,50例)和联合组(冠状动脉内注射重组人尿激酶原联合沙库巴曲缬沙坦,51例),且溶栓24 h内均行经皮冠状动脉介入治疗(PCI),并完成3个月随访。比较两组治疗前、术后1个月时心功能指标、血清硫脑苷脂、DcR3水平;并比较两组术后3个月期间心血管不良事件、不良反应发生情况。结果 术后1个月时,两组左室舒张末内径(LVEDD),左室收缩末内径(LVESD)均降低,且联合组低于对照组,左室射血分数(LVEF)均升高,且联合组高于对照组(P<0.05);两组血清硫脑苷脂水平均降低,且联合组低于对照组;血清DcR3水平均升高,且联合组高于对照组(P<0.05);联合组心血管不良事件发生率低于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论 冠状动脉内注射重组人尿激酶原联合沙库巴曲缬沙坦治疗能够改善STEMI患者心功能,降低血清硫脑苷脂水平,升高DcR3水平,降低心血管不良事件,且不增加不良反应。
Objective To explore the therapeutic effect of intracoronary injection of recombinant human prourokinase combined with sacubitril valsartan in the treatment of acute ST-elevation myocardial infarction(STEMI),and to analyze its impact on patient cardiac function,serum sulfatide,and decoy receptor 3(DcR3)levels.Methods A retrospective analysis was conducted on the clinical data of 101 patients with STEMI at the Third People’s Hospital of Henan Province from January 2022 to July 2023.According to treatment methods,patients were divided into a control group(50 cases)and a combined group(51 cases),with recombinant human prourokinase combined with sacubitril valsartan injected into the coronary artery.Percutaneous coronary intervention(PCI)was performed within 24 hours of thrombolysis,and a 3-month follow-up was completed.The cardiac function indicators,serum sulfatide,and DcR3 levels were compared between two groups before treatment and one month after surgery.The incidence of cardiovascular adverse events and adverse reactions were compared between the two groups during the 3-month postoperative period.Results At one month after surgery,LVEDD and LVESD in both groups decreased,and the combined group was lower than the control group,while LVEF increased.The combined group was higher than the control group(P<0.05).At one month after surgery,the serum sulfatide levels in both groups decreased,and the combined group was lower than the control group.The serum DcR3 levels increased,and the combined group was higher than the control group(P<0.05).The incidence of cardiovascular adverse events in the combined group was lower than control group(P<0.05).There was no statistical significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Intracoronary injection of recombinant human prourokinase combined with sacubitril valsartan can improve cardiac function,lower serum sulfatide levels,increase DcR3 levels,reduce cardiovascular adverse events,and not increase adverse reactions in STEMI patients.
作者
刘会
侯素芝
LIU Hui;HOU Suzhi(Center of Intensive Care Medicine,the Third People’s Hospital of Henan Province,Zhengzhou 450000,China)
出处
《河南医学研究》
2025年第24期4537-4541,共5页
Henan Medical Research
