Clinical application of recombinant human pro-urokinase combined with tirofiban in the treatment of acute st-segment elevation myocardial infarction

Abstract

Objective To investigate the efficacy and safety of recombinant human pro-urokinase combined with tirofiban in the treatment of acute st-segment elevation myocardial infarction. Methods 182 patients with acute st-segment elevation myocardial infarction in our hospital from August 2015 to January 2017 were selected and divided into the observation group (91 cases) and the control group (91 cases) randomly. The control group received recombinant human pro-urokinase thrombolytic therapy only; the observation group received recombinant human pro-urokinase thrombolytic therapy after hydrochloride tirofiban intravenous injection. Observed the depression of ST-segment, changes in cardiac function (LVEF, LVEDD, LVESD), and the occurrence rate of adverse reactions (including skin surface bleeding, bleeding gums, retroperitoneal hemorrhage, gastrointestinal bleeding, intracranial hemorrhage, severe thrombocytopenia, and arrhythmia). Results The complete recovery rate in the observation group was 68.1%, and the partial response rate was 26.4%, which were significantly higher than those in the control group (48.4%, 14.3%) (P<0.05); the rate of no-response in the observation group was 5.5%, which was significantly lower than that in the control group (34.7%) (P<0.01). LVEF and LVESD in the observation group were (56.1±9.3)% and (41.6±3.6)mm after the treatment, which were significantly higher than those in the control group [(51.8±8.9)%, (38.1±4.3)mm] (P<0.01); LVEDD in the observation group was (45.2±4.7)mm after the treatment, which was significantly lower than that in the control group [(47.2±3.8)mm] (P<0.01). The incidence of skin surface bleeding was 5.5% in the observation group, the incidence of retroperitoneal hemorrhage was 2.2%, the incidence of intracranial hemorrhage was 2.2%, and the incidence of arrhythmia was 24.2%, which were all significantly lower than those in the control group (P<0.05); the incidence of gastrointestinal bleeding in the observation group was 16.5%, which was significantly higher than that in the control group (3.3%) (P<0.05). Conclusions The therapy of recombinant human pro-urokinase combined with tirofiban has good effect on acute st-segment elevation myocardial infarction. It can enhance the myocardial reperfusion ability, improve the myocardial ischemia, promote the recovery of cardiac function and promote the depression of ST-segment. At the same time, it can reduce the incidence of adverse reactions and the incidence of bleeding after the treatment, which is more secure and is worthy of clinical application. Key words: Recombinant human pro-urokinase; Tirofiban; Acute st segment elevation myocardial infarction