PDF(Pubmed)
Abstract：
This study explored 1-year follow-up of Parmaco-invasive strategy with half-dose recombinant human prourokinase (PHDP) in patients with acute ST-segment elevation myocardial infarction (STEMI). The follow-up endpoints were major adverse cardiovascular events (MACEs) occurring within 30 days and 1 year, as well as postoperative bleeding events. The study ultimately included 150 subjects, with 75 in the primary percutaneous coronary intervention (PPCI) group and 75 in the PHDP group. This study found that the PHDP group had a shorter FMC-reperfusion time (42.00 min vs 96.00 min, P < 0.001). During PCI, the PHDP group had a lower percutaneous transluminal coronary angioplasty (PTCA) (P = 0.021), intropin (P = 0.002) and tirofiban (P < 0.001) use. And the incidence of intraoperative arrhythmia, malignant arrhythmia, and slow flow/no-reflow was lower in the PHDP group (P < 0.001). At the 30-day follow-up, there was a significantly higher proportion of patients in the PPCI group who were readmitted due to unstable angina (P = 0.037). After 1 year of follow-up, there was no statistically significant difference in MACEs between the two groups (P = 0.500). The incidence of postoperative major bleeding, intracranial bleeding, and minor bleeding did not differ between the PHDP and PPCI groups (P > 0.05). The PHDP facilitates early treatment of infarct-related vessels, shortens FMC-reperfusion time, and does not increase the risk of MACEs.
摘要：
这项研究探讨了半剂量重组人尿激酶原（PHDP）对急性ST段抬高型心肌梗死（STEMI）患者的辅助侵入性策略的1年随访。随访终点为30天和1年内发生的主要不良心血管事件（MACE），以及术后出血事件。这项研究最终包括150名受试者，原发性经皮冠状动脉介入治疗（PPCI）组75例，PHDP组75例。本研究发现PHDP组FMC再灌注时间较短(42.00minvs96.00min,P<0.001)。在PCI期间，PHDP组进行了较低的经皮腔内冠状动脉成形术（PTCA）（P=0.021），介绍（P=0.002）和替罗非班（P<0.001）的使用。术中心律失常的发生率,恶性心律失常,PHDP组慢流/无复流较低(P<0.001)。在30天的随访中，PPCI组因不稳定型心绞痛再次入院的患者比例明显更高(P=0.037).随访1年后,两组的MACEs差异无统计学意义(P=0.500)。术后大出血的发生率，颅内出血,PHDP组和PPCI组之间的轻微出血差异无统计学意义(P>0.05)。PHDP有助于早期治疗梗死相关血管，缩短FMC再灌注时间，并且不会增加MACE的风险。
