参麦注射液联合阿替普酶治疗急性心肌梗死的临床效果研究

目的:研究参麦注射液联合阿替普酶治疗急性心肌梗死的临床效果。方法:选择2015年1月～2016年12月在我院进行诊治的急性心肌梗死患者98例,随机分为两组,每组各49例。对照组静脉滴注阿替普酶100 mg治疗,于90 min内滴注完毕,先静脉推注15 mg,再于30 min内静脉滴注50 mg阿替普酶,最后于60 min内静脉滴注35 mg,每天1次;观察组联合静脉滴注参麦注射液治疗,每次100 mL,每天1次。比较两组的临床治疗效果,治疗前后左心室射血分数、左心室舒张末期内径、左心室后壁厚度等心功能指标及血清心肌肌钙蛋白I(c TnI)、肌酸激酶同工酶(CK-MB)、超氧化物歧化酶以及(SOD)内皮素1(ET-1)水平的变化。随访半年,观察两组的预后情况(再梗死、梗死后心绞痛、血管再通以及冠脉血栓的发生率)。结果:治疗后,观察组的有效率为91.83%(45/49),明显高于对照组71.43%(35/49)](P0.05);两组的左心室射血分数、左心室舒张末期内径、左心室后壁厚度均较治疗前明显改善(P0.05),且观察组的改善程度明显优于对照组(P0.05);两组的血清TnI、CK-MB、ET-1水平均较治疗前明显降低(P0.05),血清SOD水平均较治疗前明显升高(P0.05),且观察组以上指标的改善情况较对照组更为明显(P0.05);观察组再梗死、梗死后心绞痛以及冠脉血栓的发生率均明显低于对照组(P0.05),血管再通的发生明显高于对照组(P0.05)。结论:与单独使用阿替普酶对比,参麦注射液联合阿替普酶治疗急性心肌梗死临床疗效和安全性较好。

A Clinical Study on Shenmai Injection Combined with Batroxobin in the Treatment of Acute Myocardial Infarction

ABSTRACT Objective: To investigate the clinical effect of Shenmai injection combined with batroxobin in the treatment of acute myocardial infarction. Methods: 98 cases of patients with acute myocardial infarction who were treated in our hospital from January 2015 to December 2016 were randomly divided into two groups. The control group was given intravenous alteplase 100 mg, 90 min infusion is completed, the first intravenous injection of 15 mg, and 50 mg intravenous infusion of alteplase in 30 min, finally intravenous infusion of 35 mg in 60 min, once a day. The observation group was treated with intravenous injection of Shenmai injection, 100 mL each time, once a day. The clinical effects, changes of the left ventricular ejection fraction, left ventricular end diastolic diameter, left ventricular posterior wall thickness and other cardiac functions, serum TnI, CK-MB, SOD, ET-1 levels were detected and compared before and after half a year follow-up between two groups, the prognosis of two groups were observed and compared. Results: After treatment, the effective rate of observation group was 91.83%(45/49), which was significantly higher than that of the control group71.43%(35/49)](P<0.05). The left ventricular ejection fraction, left ventricular end diastolic diameter, and left posterior wall thickness of both groups were significantly improved after treatment(P<0.05), which improved better than those of the control group (P<0.05). After treatment, the serum levels of TnI, CK-MB and ET-1 of both groups were significantly lower than those before treatment(P<0.05), and the serum levels of SOD were significantly increased(P<0.05), which improved more obviously in the observation group than those of control group(P<0.05). The incidence of reinfarction, post infarction angina pectoris and coronary thrombosis of observation group were lower than those of the control group (P<0.05), and the incidence of recanalization was significantly higher than that of the control group (P<0.05). Conclusion: The clinical effect and safety of Shenmai injection combined with batroxobin in the treatment of acute myocardial infarction weer better than batroxobin alone.