丹参川芎嗪注射液联合替罗非班治疗急性ST段抬高型心肌梗死的临床研究

目的探讨丹参川芎嗪注射液联合替罗非班治疗急性ST段抬高型心肌梗死(STEMI)的疗效。方法选取2013年3月—2015年12月在首都医科大学附属北京潞河医院心血管内科行PCI的STEMI患者120例,随机分为对照组和治疗组,每组各60例。对照组在PCI后30 min内静脉滴注注射用盐酸替罗非班,起始剂量为3μg/kg,而后以0.06μg/(kg·min)微量静脉滴入,1次/d。治疗组在对照组治疗基础上静脉滴注丹参川芎嗪注射液,15 mL加入5%葡萄糖溶液200 mL,3次/d。两组均连续用药6 d。观察治疗前后两组患者血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)、血红蛋白、血小板的变化。比较两组心脏不良事件包括心源性死亡、心肌再梗死、再次靶血管血运重建的发生情况。结果治疗后,两组CK、CK-MB和LDH均显著降低,同组治疗前后差异有统计学意义(P0.05);治疗组降低的更显著,两组间比较差异具有统计学意义(P0.05)。住院期间,对照组和治疗组发生心脏不良事件的总发生率分别为13.33%、8.33%;术后45 d两组的总发生率分别为10.00%、3.33%,两组总发生率比较差异有统计学意义(P0.05)。治疗后,两组患者血红蛋白和血小板均没有发生明显变化。结论丹参川芎嗪联合替罗非班治疗急性ST段抬高型心肌梗死可降低心肌梗死程度,降低不良事件发生率,且无严重不良反应发生,具有一定的临床推广应用价值。

Clinical study on Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with tirofiban in treatment of acute ST segment elevation myocardial infarction

Objective To explore the clinical efficacy of Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with tirofiban in treatment of acute ST segment elevation myocardial infarction (STEMI). Methods Patients (120 cases) with STEMI who accepted PCI in Department of Cardiovascular Internal Medicine of Beijing Luhe Hospitial Capital Medical University from March 2013 to December 2015 were randomly divided into control and treatment groups. Each group had 60 cases. The patients in the control group were iv administered with Tirofiban Hydrochloride for injection in 30 min after PCI, and the starting dosage was 3μg/kg, and then 0.06μg/(kg·min) trace intravenous drip, once daily. The patients in the treatment group were iv administered with Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection on the basis of the control group, 15 mL added into 5% glucose solution 200 mL, three times daily. The patients in two groups were treated for 6 d. After treatment, the changes of CK, CK-MB, LDH, hemoglobin, and platelet before and after treatment in two groups were compared. The occurrence of cardiac adverse events including cardiac death, myocardial infarction again, and target blood vessels reascularization again in two groups were compared. Results After treatment, CK, CK-MB, and LDH in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P<0.05). During the period of hospitalization, the total incidence of adverse events in the control and treatment groups were 13.33% and 8.33%, respectively, and after 45 d, the total incidence of adverse events were 10.00%and 3.33%, respectively, and there were differences between two groups (P<0.05). After treatment, hemoglobin and platelet in two groups had no obvious changes. Conclusion Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection combined with tirofiban can decrease the degree of myocardial infarction in treatment of acute ST segment elevation myocardial infarction, and can reduce the incidence of adverse events with no serious adverse reactions, which has a certain clinical application value.