生脉注射液联合曲美他嗪治疗急性心肌梗死溶栓再通患者的临床疗效观察

目的观察生脉注射液联合曲美他嗪对急性心肌梗死再灌注治疗后心肌细胞的保护作用。方法将100例入进再灌注溶栓治疗的患者随机分成治疗组和对照组，治疗组配合生脉注射液40ml静滴、曲美畸他嗪20mg口服，3次/d。对照组只做溶栓治疗，比较两组再通患者间肌酸激酶同工酶（CK-MB）峰值浓度，CK-MB恢复正常的时间及再灌注心律失常；随访6个朋观察心脏事件发生率。结果①治疗组再通者CK和CK-MF峰值浓度分别为（1265±728）和（114±67）U／L，显著低于对照组的（1769±713）和（159±67）U／L（P〈0．05）；治疗组CK和CK-MB峰值时间和恢复正常的时间均显著低于对照组（P〈0．05,0．01）。②治疗组9例（30%）再灌注心律失常，显著低于对照组15例53.5％（P〈0．05）。③近期心脏事件发生率明显优于对照组（P〈0.05）。结论生脉注射液联合曲美他嗪对溶栓再通的急性心肌梗死患者可缩小梗死面积，减轻再灌注损伤，降低近期心脏事件发生率。

The Effect of Pulse-activating Injection Combined with Intravitreal on Acute Myocardial Infarction-reperfusion Cardiac Muscle

Objective To study the protective effect of pulse-activating injection combined with intravitreal on acute myocardial infarction-reperfusion cardiac muscle. Methods One-hundred patients with reperfusion thrombolysis therapy were randomly divided into 2 groups, one group received pulse-activating injection （40mg） by intravenous drip and trimetazidine 20mg thrice per os daily after thrombosis therapy, the other group received thrombosis therapy only. The peak contraction of CK-MB, normalization time of CK-MB and the rate of cardiac event reoccurrence namely reperfusion arrhythmia between the two groups were compared. Results （1）The peak contraction of CK-MB and CK in recanalization patients of treatment group were （1265 ± 728）U/L, （114 ±67） U/L respectively,while in control group were （1769 ±713） U/L, （159 ±67）U/L（ P 〈 0.05）; The normalization time of treatment group is also lower than that of the control group （ P 〈 0.01 ）. （2）Nine patients （ 30% ） reoccurred reperfusion arrhythmiain in treatment group, 15patients （53.5% ） in the control group （ P 〈 0.05 ）. （3）The rate of cardiac event occurrence of treatment group is lower than that of the control group（ P 〈 0. 05 ）. Conclusion Pulse-activating injection combination with trimetazidine could reduce infarct size, extenuate reperfusion injury after thrombosis recanalization thwrapy, and lower the rate of cardiac event occurrence.