Efficacy of different doses of recombinant human prourokinase combined with sodium nitroprusside in patients with STEMI

WEI Guoshi; XU Tingting; JIANG Nan

doi:10.3969/j.issn.1672-8157.2026.02.007

Abstract：Objective To analyze the clinical efficacy of different doses of recombinant human prourokinase com-bined with sodium nitroprusside in the treatment of patients with acute ST-segment elevation myocardial infarction(STEMI).Methods A retrospective controlled study was adopted.A total of 82 STEMI patients admitted to Luoyang Central Hospital from March 2023 to March 2025 were analyzed.All patients underwent percutaneous coronary intervention and received con-ventional drug therapy.According to the medical records,patients who actually received 10 mg of recombinant human prouroki-nase combined with sodium nitroprusside were assigned to the low-dose group(41 cases),while those who actually received 20 mg of recombinant human prourokinase combined with sodium nitroprusside were assigned to the high-dose group(41 cases).Data on reperfusion status,cardiac function improvement,serological indicators,bleeding events,and adverse reactions were ex-tracted from the medical records for comparative analysis.Results In the high-dose group,Thrombolysis in Myocardial Infarc-tion(TIMI)grade was as follows:grade 0 in 3 cases(7.32%),grade Ⅰ in 4 cases(9.76%),grade Ⅱ in 8 cases(19.51%),and gradeⅢ in 26 cases(63.41%).In the low-dose group,it was grade 0 in 5 cases(12.20%),grade Ⅰ in 8 cases(19.51%),grade Ⅱ in 15 cases(36.59%),and grade Ⅲ in 13 cases(31.71%).The high-dose group showed better results than the low-dose group(Z=-2.630,P<0.05).In the high-dose group,Myocardial Blush grade was as follows:grade 0 in 2 cases(4.88%),grade Ⅰ in 5 cases(12.20%),grade Ⅱ in 15 cases(36.59%),and grade Ⅲ in 19 cases(46.34%).In the low-dose group,it was grade 0 in 6 cases(14.63%),gradeⅠ in 10 cases(24.39%),grade Ⅱ in 18 cases(43.90%),and grade Ⅲ in 7 cases(17.07%).The high-dose group was superior to the low-dose group,with a statistically significant difference(Z=-3.018,P<0.05).After treatment,the electrocardiographic ST seg-ment resolution rate in the high-dose group was as follows:complete recovery in 27 cases(65.85%),partial recovery in 12 cases(29.27%),and no recovery in 2 cases(4.88%),while in the low-dose group,it was complete recovery in 17 cases(41.46%),par-tial recovery in 16 cases(39.02%),and no recovery in 8 cases(19.51%).The high-dose group was superior to the low-dose group,with a statistically significant difference(Z=2.451,P<0.05).Compared with the low-dose group,the high-dose group showed a lower postoperative peak troponin I level((3.15±0.82)μg/L vs(3.58±0.96)μg/L)and a shorter time to peak((12.67±2.54)h vs(14.97±2.58)h),and the postoperative peak of Creatine Kinase-MB(CK-MB)decreased in the high-dose group((352.62±51.83)U/L vs(385.72±56.14)U/L),with a shorter time to peak((11.47±1.83)h vs(13.06±1.75)h)(t=2.181,4.068,2.774,4.021,all P<0.05).After treatment,compared with the low-dose group,the high-dose group showed a higher left ventricular ejection fraction((50.62±3.44)%vs(48.96±3.51)%,t=2.163,P<0.05)and a lower N-terminal pro-B-type natriuretic peptide level((742.83±129.64)ng/L vs(895.73±136.25)ng/L,t=5.226,P<0.05).There was no statistically significant difference in TIMI bleeding grade between the low-dose group and the high-dose group(19.51%(8/41)vs 29.27%(12/41),χ2=1.058,P>0.05).The difference in the incidence of adverse reactions between the two groups was not statistically significant(12.20%(5/41)vs 14.63%(6/41),χ2=0.105,P>0.05).Conclusion For STEMI patients,recombinant human prourokinase combined with sodium nitroprusside can effectively improve myocardial reperfusion and enhance cardiac function.Moreover,the therapeutic effect is further en-hanced with an increased dose of rhPro-UK,while maintaining a favorable safety profile.