Effects of ulinastatin slow flow and no reflow phenomenon during emergency percutaneous coronary artery intervention / 中国介入心脏病学杂志

ABSTRACT

Objective To study the effect of ulinastatin on no reflow or slow flow in the infarct related artery in patient with acute ST-elevation myocardial infarction (STEMI) undergoing emergency percutaneous coronary interventional therapy (PCI).Methods 180 STEMI patients were divided into the control group (n=100) and the ulinastatin treatment group (n=80).The control group received conventional PCI treatment and the treatment group received conventional PCI treatment plus ulinastatin. The level of serum inflammatory factors IL-6,IL-10,superoxide converting enzyme,the infarct related coronary artery reperfusion TIMI flow grade (TFG) and myocardial perfusion grade (TMPG),the results of postoperative cardiac ultrasound examination and clinical outcomes were compared between the two groups.Results Compared with the control group,the level of IL-6 was decreased,while the levels of IL-10 and superoxide converting enzyme were increased significantly in the ulinastatin treatment group(P<0.05).The TFG and TMPG of the infarct related vessels were increased significantly in the ulinastatin treatment group. The left ventricular end diastolic diameter[(54.6 ± 5.2 mm vs. (50.4±4.6) mm,P=0.046)]and left ventricular ejection fraction [(58.4±10.2) % vs. (62.2±9.8) % P=0.048] showed statistical difference between the two groups.Compared to the control,the major cardiovascular event rate of the treatment group during hospitalization (1% vs. 5%, P=0.038), after one month (1.2% vs. 3%,P=0.046) and 6 months (3% vs 12%,P=0.018) were all significantly lower .There was no significant difference in mortality between the 2 groups.Conclusion Ulinastatin may lower the incidence of no flow and slow flow after emergency PCI,improve heart function and the lower the rates of MACE.