OBJECTIVE: To probe into the improvement of combined application of sodium nitroprusside and recombinant human prourokinase in coronary artery on no-reflow in elderly patients with acute ST segment elevation myocardial infarction（ STEMI） during emergency percutaneous coronary intervention（ PCI）. METHODS: Totally 60 patients with no-reflow during STEMI emergency PCI admitted into our hospital from Mar. 2017 to Mar. 2019 were extracted to be divided into the observation group and the control group via the random number table

with 30 cases in each group. The control group was treated with sodium nitroprusside alone

while the observation group received sodium nitroprusside + recombinant human prourokinase. The cardiac function parameters after surgery of 1 week and1 month

TIMI blood flow grading

bleeding during surgery and after surgery of 24 h

major adverse cardiac events（ MACE） after surgery of 1 month were compared between two groups. RESULTS: After treatment

the TIMI blood flow grading three of the observation group and the control group were respectively 28 cases（ 93. 33%） and 20 cases（ 66. 67%）. In terms of TIMI blood flow grading

the observation group was significantly better than the control group

with statistically significant difference（ P < 0. 05）. After surgery of 1 months

the left ventricular end-diastolic diameter of the observation group was significantly lower than that after surgery of 1 week

and was significantly lower than that of the control group during the same period; the left ventricular ejection fraction of the observation group was significantly higher than that after surgery of 1 week

and was significantly higher than that of the control group during the same period

the difference was statistically significant（ P < 0. 05）. The rates of bleeding during surgery and after surgery of 24 h in the observation group and the control group were respectively 16. 67%（ 5/30） and 10. 00%（ 3/30）

and the incidence of MACE after surgery of 1 month were respectively 6. 67%（ 2/30） and 20. 00%（ 6/30）

the difference between two groups was not statistically significant（ χ2= 0. 144

P = 0. 704; χ2= 2. 401

P =0. 254）. CONCLUSIONS: Combined application of sodium nitroprusside and recombinant human prourokinase in coronary artery can effectively increase myocardial perfusion in patients with STEMI during emergency PCI

and improve the cardiac function of patients.