目的 探討重組人尿激酶對急性ST段抬高型心肌梗死的臨床療效及炎癥因子的影響。方法 選取2016年3月-2018年3月在三門峽市中心醫(yī)院住院治療的ST段抬高型心肌梗死患者110例，采用隨機(jī)數(shù)字法分為研究組（55例）和對照組（55例），對照組患者給予常規(guī)治療，研究組患者在常規(guī)治療的基礎(chǔ)上給予重組人尿激酶進(jìn)行治療，比較兩組患者的血管再通率及主要不良心血管事件（MACE）的發(fā)生率，并測定治療前后超敏C反應(yīng)蛋白（hs-CRP）、白介素-6（IL-6）、單核細(xì)胞趨化蛋白（MCP-1）、人組織纖溶酶原激活物（t-PA）和人纖溶酶原激活物抑制劑（PAI-1）的水平。結(jié)果 研究組患者的血管再通率為81.82%，對照組患者的血管再通率為63.64%，差異具有統(tǒng)計學(xué)意義（P<0.05）。治療前，兩組患者的PAI-1、t-PA、hs-CRP、IL-6及MCP-1相比，差異無統(tǒng)計學(xué)意義；治療后，兩組患者的hs-CRP、IL-6及MCP-1水平均明顯降低，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且研究組患者的hs-CRP、IL-6及MCP-1顯著低于對照組，差異具有統(tǒng)計學(xué)意義（P<0.05）；治療后，兩組患者PAI-1明顯降低，而t-PA顯著升高，同組治療前后比較差異有統(tǒng)計學(xué)意義（P<0.05）；且研究組患者PAI-1顯著低于對照組，而t-PA顯著高于對照組，差異具有統(tǒng)計學(xué)意義（P<0.05）。研究組患者的MACE發(fā)生率為6例（10.91%），對照組患者的MACE發(fā)生率為17例（30.91%），差異具有統(tǒng)計學(xué)意義（P<0.05）。結(jié)論 重組人尿激酶能夠顯著提高急性ST段抬高型心肌梗死患者的血管再通率、降低炎癥反應(yīng)及主要不良心血管事件的發(fā)生率。

Objective To investigate the effect of clinical effect and inflammatory factor of prourokinase in the treatment with STsegment elevation myocardial infarction. Methods 110 cases ST-segment elevation myocardial infarction patients from March 2016 to March 2018 in our hospital, according to the random number divided into research group (55 cases) and control group (55 cases), the control group was given routined treatment, the research group was given recombinant human urokinase on the basis of routine treatment, compared with the vessel repass rate and the incidence of the major adverse cardiovascular events, and tested the level of high-sensitivity C-reactive protein, IL-6, monocyte chemo-attractant protein-1, human tissue-plasminogen activator and human plasminogen activator inhibitor 1. Results The vessel repass rate of the research group is 45 cases (81.82%), the vessel repass rate of the 35 cases (63.64%), the difference was statistically significant (P<0.05). Compared with the PAI-1, t-PA, hs-CRP, IL-6 and MCP-1 of the two groups before treatment, the difference was not statistically significant. After treatment, the PAI-1, hs-CRP, IL-6 and MCP-1 of the research group was significantly lower than control group, but the t-PA significantly increased, the difference was statistically significant (P<0.05). The incidence of MACE of the research group is 6 cases (10.91%), the incidence of MACE of the control group is 17 cases (30.91%), the difference was statistically significant (P<0.05). Conclusion Prourokinase can significantly improved the vessel repass rate of the acute ST-segment elevation myocardial infarction, and decreased the inflammatory response and the incidence of the major adverse cardiovascular events.