Clinical study of recombinant human prourokinase in the treatment of acute ST-segment elevation myocardial infarction

ObjectiveTo 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).

MethodsA total of 126 patients, including 61 patients in the observation group.After the discovery of the criminal's blood vessels by coronary angiography, 20 mg of recombinant human prourokinase 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 TnI and CK-MB, the cardiac function, bleeding events during hospitalization, major adverse cardiovascular events (MACEs) and MACEs at 1 month after operation were compared and observed between the two groups.

ResultsThe peak levels of serum CK-MB and TnI in the observation group were significantly lower than those in the control group(P < 0.05).The falling rate of ST-segment in the observation group was significantly higher than that in the control group(P < 0.05).There was no significant difference in the levels of left ventricular ejection fractions (LVEF) and left ventricular end-diastolic dimension (LVEDd) between the two groups on the first day after PCI operation(P>0.05), and the NT-proBNP content in the observation group was lower than that in the control group (P < 0.05).One month after operation, the levels of LVEF and LVEDd in the observation group were significantly better than those in the control group(P < 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 months after operation between the two groups.

ConclusionsIntracoronary administration of prourokinase via balloon catheter during primary PCI can effectively improve myocardial perfusion and short-term cardiac function in patients with STEMI without increasing the risk of bleeding.