心梗静脉溶栓患者序贯应用左卡尼汀和曲美他嗪疗效分析

目的研究序贯应用左卡尼汀和曲美他嗪对心梗静脉溶栓患者的临床疗效。方法选取急性心梗行静脉溶栓的患者80例,随机分为左卡尼汀联合曲美他嗪治疗组及常规治疗对照组。观察比较两组间血管再通情况以及再灌注损伤情况,行超声检查比较两组间左室舒张末压(LVDF)及心脏射血分数(LVEF)的值。结果治疗组血管再通率、胸痛缓解时间、心肌标志物(肌酸激酶同工酶、肌钙蛋白)峰值出现时间70%;(1.70±0.19)h;(12.0±0.21)h;(14.0±0.13)h]与对照组比较67.5%;(1.65±0.25)h;(12.1±0.19)h;(15.0±0.06)h],差异无统计学意义(P>0.05);发生再灌注严重心律失常、泵衰竭及再发心绞痛患者数,治疗组(9例,6例,4例)与对照组比较(19例,15例,12例),差异有统计学意义(P<0.05)。LVDF和LVEF数值,治疗组(45±1.6)mm,(59±1.0)%]与对照组(52±2.0)mm,(54±2.1)%]比较,差异有统计学意义(P<0.05)。结论左卡尼汀和曲美他嗪对血管再通无作用,但能够缓解缺血再灌注损伤,保护或改善心肌功能。

Effect of L-carnitine and trimetazidine on patients with acute myocardial infarction undergoing thrombolytic

Objective To evaluate the effects of L-carnitine （L-CN） and trimetazidine （TMZ） on patients with acute myocardial infarction （AMI） undergoing thrornbolytic therapy. Methods 80 patients with AMI undergoing thrombolytic were divided into drug treatment（ L-carnitine and trimetazidine group） group and regular group,40 cases in each group. To compare the data of reperfusion and injury. Left ventricular diastolic diameter （LVDF） and left ventricular ejection fraction （LVEF） were detected. Results There were no difference with reperfusion incidence and time of chest pain release and peak value of CK-MB and cTnT between drug treatment group70% ; （ 1.70±0. 19）h; （12.0±0.21）h;（14.0±0. 13） hi and regular group 67. 5% ; （1. 65 ±0.25）h;（12.1±0.19）h;（15.0±0.06）h] （P 〉 0. 05 ）. The incidence of severe arrhythmia, heart failure and angina were different between drug treatment group （9, 6,4） and regular group （19,15,12） （P 〈0. 05）. The data of LVDF and LVEF had significant difference between drug treatment group （45 ± 1.6） ham,（59 ± 1.0）%] and regular group E（52 2±2.0）mm,（54 ±2.1）%] （P〈0.05, P 〈 0. 05 ）. Conclusion L-carnitine and Trtmetazidine can inhibit reperfusion injury and improve left ventricular function.