参麦注射液联合尿激酶溶栓治疗前壁急性心梗临床分析

目的观察参麦注射液联合尿激酶溶栓治疗急性前壁心肌梗死（AMI）患者的疗效,并探讨其对患者的心功能等相关指标的影响。方法将我院收治的68例急性心肌梗死患者随机分为观察组和对照组各34例,对照组采用常规的西药（阿司匹林、吗啡、尿激酶、低分子肝素等）进行治疗,观察组则在对照组治疗的基础上加用静脉滴注参麦注射液治疗,比较两组患者治疗后的溶栓效果、心功能、缺血修饰性蛋白（IMA）、肌酸激酶同工酶（CK-MB）、脑钠肽（BNP）、超氧化物歧化酶（SOD）活性及丙二醛（MDA）的水平变化。结果两组患者经溶栓治疗后,其胸痛缓解、ST段回降、心肌酶峰值提前、再通率提高,两组比较差异均无统计学意义（P〉0.05）,但在心律失常发生率方面比较,观察组明显低于对照组,差异具有统计学意义（P〈0.05）;两组治疗前后各组内IMA、CK-MB、BNP、SOD、MDA进行比较,观察组的IMA、CK-MB、BNP、SOD、MDA均呈现不同程度的下降或者上升,差异具有统计学意义（P〈0.05）;对照组仅IMA、CK-MB、BNP与治疗前差异具有统计学意义（P〈0.05）;治疗后两组间BNP、SOD、MDA水平比较差异均具有统计学意义（P〈0.05）;但两组的左室舒张末内径、射血分数比较差异均无统计学意义（P〉0.05）;两组治疗后的心力衰竭、休克、死亡发生率比较差异也均无统计学意义（P〉0.05）,但心绞痛发生率差异具有统计学意义（P〈0.05）。结论常规溶栓治疗基础上加用参麦注射液有利于减少溶栓治疗后的并发症,改善心肌酶指标,改善预后。

Clinical analysis of ginseng injection with urokinase thrombolysis therapy in anterior wall acute myocardial infarction

Objective To observe the effect of ginseng injection with urokinase thrombolysis therapy in acute anterior wall myocardial infarction（AMI） patients, and to discuss its impact on cardiac function. Methods Sixty-eight patients with acute myocardial infarction in our hospital were selected, and randomly divided into observation group and control group with 34 cases in each group. The control group was treated with routine method（aspirin, morphine, urokinase, low molecular weight heparin）, while the observation group was treated with intravenous drip injection of ginseng injection in addition to the treatment in the control group. The heart function, ischemia modified protein（IMA）, creatinekinase isoenzyme（CK-MB）, brain natriuretic peptide（BNP）, superoxide dismutase（SOD） activity and malondialdehyde（MDA） levels were compared in patients between the two groups. Results There was no statistical significant differences in recanalization rate of reduction in ST segment elevation, chest pain, myocardial enzyme, and peak early recanalization（rate） between the two groups after thrombolysis treatment（P〉0.05）, but the incidence of arrhythmia in the observed group was significantly lower than in the control group（ χ^2=6.071, P=0.0140.05）. The IMA,CK-MB, BNP, SOD and MDA in the observation group were decreased or increased before and after treatment with statistical significance（P〈0.05）, while only the IMA CK-MB and BNP in the control group had statistically significant difference with those before the treatment（P〈0.05）. There were statistically significant differences in BNP, SOD, MDA level between the two groups after treatment（P〈0.05）. There were no significant differences in left ventricular end diastolic diameter, ejection fraction, the heart failure, shock and death between the two groups after treatment（P〉0.05）, but there was a statistically significant difference in the incidence of angina pectoris between the two groups（χ^2=11.77, P〈0.05）. Conclu