参麦注射液辅助治疗急性ST段抬高型心肌梗死溶栓的作用机制

目的:探讨参麦注射液辅助用于急性ST段抬高型心肌梗死溶栓治疗后对心肌损伤的保护作用。方法:选取在我院接受治疗的急性ST段抬高型心肌梗死(STEMI)患者120例,分为对照组和实验组各60例。对照组采用瑞通立溶栓,实验组在对照组治疗的基础上增加参麦注射液。观察两组冠脉再通情况;检查治疗前后左室射血分数(LVEF)和左心室舒张末期内径(LVEDD),记录再发心梗、再发心绞痛、恶性心律失常、泵衰竭、心源性死亡的发生情况;记录ST段回复情况及ST段恢复正常时间;观察肌酸激酶(CK)和肌酸激酶同工酶(CK-MB)峰值时间及恢复正常时间。结果:采用秩和检验,实验组临床疗效显著优于对照组(P0.01);治疗后实验组左室射血分数(LVEF)高于对照组(P0.05);两组冠脉再通率分别为78.33%和88.33%,实验组高于对照组,但差异无统计学意义;对照组不良心血管事件累积发生率为95%,高于实验组的63.33%(P0.01);治疗后实验组ST段平均回落幅度多于对照组(P0.01),ST段恢复正常短于对照组(P0.01);治疗后实验组CK和CK-MB峰值时间及恢复正常时间均短于对照组(P0.01)。结论:参麦注射液辅助用于急性ST段抬高型心肌梗死溶栓治疗后患者能改善患者心功能,减轻缺血再灌注损伤,改善心肌供血,保护心肌,减少不良心血管事件的发生。

Action Mechanism of Adjuvant Therapy of Shenmai Injection in Treating Acute ST-segment Elevation Myocardial Infarction

Objective: To discuss the effectiveness and safety of Shenmai injection in treating patients with acute ST-segment elevation myocardial infarction (STEMI). Method: One hundred and twenty STEMI patients were selected from our hospital and randomly divided into the control group and the experimental group of 60 patients each. The patients in the control group received reteplase for injection. On the basis of the control group, the patients in the experimental group added Shenmai injection. The left ventricular ejection fraction (LVEF) and left ventricular end-diastolic diameter (LVEDD), the incidence of myocardial in farction recurrent, stable angina, congestive heart-failure, cardiac death, arrhythmia, peak time and recovery time of creatine kinase (CK) and CK isoenzyme-MB (CK-MB), recovery situation and time of ecg ST segment, length of hospital stay and injection adverse reaction data of patients in both two groups were observed. Result: The clinical effect in the experiment group was superior to that in the control group (P<0.01). After treatment, LVEF in the experiment group was higher than that in the control group (P<0.05). Reperfusion rates of coronary in two groups were 78.33% and 88.33%, respectively, while there was no significant difference between two groups. The cumulative incidence rate of adverse cardiovascular events in the experiment group was 95%, which was higher than that of 63.33% in the control group (P<0.01). The average ST-segment elevation resolution was higher, recovery time of ST-segment was shorter, peak time and recovery time of CK and CK-MB were shorter in the experiment group than those in the experiment group (P<0.01). Conclusion: Shenmai injection combined with reteplase could improve cardiac function, relieve ischemia-reperfusion injury, ameliorate blood flow in the heart muscle, protect heart muscle and reduce the happening of bad cardiovascular event in treating STEMI.