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Objective:To explore the effect of coronary injection of recombinant human prourokinase (rhPro-UK) during PCI for ST-segment elevation acute myocardial infarction (STEMI) patients.Methods:A total of 124 STEMI patients treated in Tangshan Gongren Hospital, Hebei Province from November 2018 to November 2019 were selected as the research objects.They were simply randomized by random number table method into the observation group(63 cases) and the control group(61 cases). Thrombus aspiration was used.The control group was treated with 25 μg/kg tirofiban, and the observation group was injected with 20 mg rhPro-UK into the coronary arteries.After that, both groups underwent emergency PCI treatment.The bleeding degree, myocardial microcirculation indexes, plasma fibrinolytic factor changes, vascular recanalization, ST segment fall of electrocardiogram and changes in left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD), left ventricular ejection fraction (LVEF), cardiac index (CI) were recorded.Results:The peak value of creatine kinase isoenzymes MB (CK-MB) (184.64±21.47) U/L and the peak time of CK-MB (14.32±2.02) h in the observation group were significantly lower than those in the control group((258.94±31.64) U/L, (16.58±2.09) h), the differences were statistically significant ( t=15.345 and 6.123, all P<0.001). After treatment, human tissue plasminogen activator (t-PA) (0.85±0.28) kU/L in the observation group was significantly higher than that in the control group (0.74±0.24) kU/L, human plasminogen activator inhibitor (PAI-1) (0.16±0.05) kU/L.compared with the control group (0.32±0.08) kU/L significantly decreased ( t=2.345, P=0.021; t=13.401, P<0.001); 77.78% (49/63) of the ST-segment complete fall in observation group was significantly higher than 54.10% (33/61) of the control group ( Z=7.758; P=0.005), and 4.76% (3/63) in the observation group without a fall in ST segment was significantly lower than 19.67% (12/61) of the control group ( Z=6.480; P=0.011). The LVEDD at 7 days, 14 days and the LVESD at 7 days and 14 days in the observation group were (49.37±3.14) mm, (48.34±3.03) mm, (33.19±2.23) mm and (32.05±2.23) mm respectively, which were significantly lower than those in the control group at 7 days, (50.64±3.03) mm, (49.66±2.83) mm, (34.86±1.73) mm and 14 days, (33.74±1.97) mm respectively ( P<0.05 or P<0.001). The LVEF of 7 days and 14 days after treatment were (56.32±4.97)% and (59.23±5.11)%, which were significantly higher than those of the control group (54.46±4.87)% and (57.18±4.33)% ( P<0.05 or P<0.001). CI at 7 days and 14 days after treatment were (3.65±0.22) L/ (min·m 2) and (3.76±0.21) L/(min·m 2), which were significantly higher than those of the control group (3.48±0.25) L/(min·m 2) and (3.56±0.24) L/(min·m 2)( P<0.05 or P<0.001). Conclusion:STEMI patients treated by intraoperative coronary injection of Rhpro-UK versus tirofeban, can further improve the total bleeding rate and the vascular recanalculation rate, and also significantly improve plasma fibrinolysis factor, myocardial microcirculation and cardiac function.This provides an alternative to the treatment of myocardial infarction in patients with STEMI.
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Objective To investigate the efficacy of low-frequency repetitive transcranial magnetic stimulation (rTMS) treatment of patients with alcohol dependence,anxiety and depression,and sleep problems.Methods 80 patients with alcohol-dependent patients were randomly divided into experimental group (40 cases) and control group (40 cases).All patients received routine treatment and care,the experimental group received additional rTMS to stimulate parts of the bilateral dorsolateral prefrontal region (DLPFC) 2 brain regions,each side 15 minutes at frequency of 1Hz,patient motion stimulus,intensity threshold (MT) of 80％,five times a week rTMS treatment,a total of 8 weeks,the control group received stimulation coil.Subjects were interviewed,as the time for the baseline,2 weeks,4 weeks and 8 weeks,assessment tools for the hamilton anxiety scale (HAMA),Hamilton depression rating scale (HAMD),Pittsburgh sleep quality index (PSQI).Results Compared with the pre-treatment,HAMA scores (19.5 ± 6.4,13.8± 5.3,7.3± 5.4 respectively) were significantly lower in 2,4,8 weeks after treatment (t 2 =11.29,P＜0.01;t 4=15.26,P＜0.01;t s =9.40,P＜0.01).Compared with the control group,HAMA scores were significantly lower in the experimental group after treatment (P＜0.01).Compared with the pretreatment group HAMD scores(17.5±6.6,11.2±4.9,6.1±5.2 respectively)were significantly lower in 2,4,8 weeks after treatment (t 2 =15.54,P＜0.01;t 4 =16.68,P＜0.01;t s =18.77,P＜0.01).Compared with the control group,HAMD scores were significantly lower in the experimental group after treatment (P＜0.01).Compared with the control group,PSQI scores were significantly lower in the experimental group in 2,4,8 weeks after treatment (t 2 =26.39,P＜0.01;t4=15.21,P＜0.01;ts=46.35,P＜0.01).Condusion Low-frequency rTMS treatment for alcohol dependence withdrawal symptoms can improve symptoms,such as anxiety and depression,sleep status.
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Objective To study effects of strengthened atorvastatin treatment on homocysteine( Hcy) and N-terminal B-type natriuretic peptide( NT-proBNP) in patients with non-ST-segment elevation acute coronary syndrome. Methods 120 patients with non-ST-segment elevation acute coronary syndrome were randomly divided into the two groups,the observation group(n=60 cases) and the control group(n=60 cases).The patients in the observation group were treated through the basis of conventional therapy plus atorvastatin 40mg/night treatment,while the patients in the control group were treated through the basis of conventional therapy plus atorvastatin 20mg/night treatment. They were all treated for two months.Plasma Hcy and NT-proBNP were detected before and after treatment.Results Hcy in the observation group and the control group before treatment were ( 25.5 ±8.6 )μmol/L and ( 26.3 ± 9.1)μmol/L,respectively,(10.3 ±4.7)μmol/L and (16.9 ±7.1)μmol/L after treatment.NT-proBNP in the obser-vation group and the control group before treatment were (374.7 ±39.2)ng/L and (359.6 ±36.1)ng/L,respective-ly,(127.4 ±15.3)ng/L and (237.1 ±24.3)ng/L after treatment.After treatment,plasma Hcy and NT-proBNP were significantly reduced than those before treatment and after treatment(P<0.05).During follow-up,the two groups showed no elevated liver enzymes and muscle enzymes and lead to withdrawal from happening.Conclusion Strength-ened atorvastatin treatment can significantly reduce Hcy and NT-proBNP in patients with non-ST-segment elevation acute coronary syndrome.
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Objective To explore the influence of fasudil on plasma hydrogen sulfide(H2S)and N-terminal B-type natriuretic peptide( NT-proBNP) in patients with chronic pulmonary heart disease.Methods According to the digital table,102 patients with chronic pulmonary heart disease were randomly divided into the observation group and the control group, each group in 51 cases.The patients in the control group were treated through the conventional treatment,while the patients in the observation group were treated through the conventional treatment plus fasudil. They were treated for 14 days.The mean pulmonary artery pressure( MPAP) ,plasma H2 S and NT-proBNP were detec-ted.Results After treatment,the total effective rate in the observation group was 96.1%,which was higher than 86.3%in the control group(χ2 =4.046,P<0.05).MPAP in the two groups of patients were significantly decreased, and the observation group decreased more significantly than the control group(t=7.246,P<0.05).After treatment, plasma H2S were significantly higher,and the observation group increased more significantly(t=2.856,P<0.05), plasma NT-proBNP in two groups after treatment were significantly reduced,and the observation group decreased sig-nificantly(t=10.706,P<0.05).Conclusion Fasudil can be significantly improved plasma H2S and NT-proBNP in patients with chronic pulmonary heart disease.