注射用益气复脉（冻干）治疗心肌梗死后心源性休克疗效观察

目的 评价注射用益气复脉（冻干）治疗心肌梗死后心源性休克的临床疗效。方法 回顾性选取2018年12月—2019年12月就诊于吉林大学第一医院心内科重症监护室的79例心源性休克患者为研究对象，根据治疗方法分为对照组（n=45）和观察组（n=34），对照组按照心肌梗死后心源性休克指南予以常规治疗即氧疗、重症监护、纠正内环境紊乱，予以镇痛、镇静、升压等血管活性药物及纠正心衰及心律失常药物，代表药物有多巴胺、去甲肾上腺素等；观察组在对照组基础上予以注射用益气复脉（冻干）5.2 g加入5%葡萄糖注射液250 mL（若患者血糖高改为0.9%氯化钠注射液250 mL）静脉滴注，静滴速度<20滴/min，1次/d，连用7 d。记录两组患者出院时死亡率，比较两组治疗前后心率（HR）、收缩压（SBP）、舒张压（DBP）、乳酸、白细胞及白蛋白等变化情况，观察注射用益气复脉（冻干）静脉滴注期间及用药后1 h不良反应。结果 观察组出院时死亡率为38.2%，对照组为75.6%，两组差异有统计学意义（P<0.05）；观察组SBP、DBP、乳酸指标改善情况优于对照组，两组差异有统计学意义（P<0.05）；观察组存活患者中HR、白蛋白及白细胞改善情况与对照组比较差异无统计学意义（P>0.05）；观察组在应用益气复脉（冻干）期间及结束后1 h未见不良反应。结论 心肌梗死后心源性休克患者在常规治疗基础上采用益气复脉（冻干）治疗有效，临床应用相对安全，可改善患者预后，具有一定的临床推广价值。

Therapeutic effect of Yiqi Fumai Lyophilized Injection on cardiogenic shock after myocardial infarction

Objective To evaluate the clinical efficacy of Yiqi Fumai Lyophilized Injection in treatment of cardiogenic shock after myocardial infarction. Methods Total 79 patients with cardiogenic shock treated in the intensive care unit of the Department of Cardiology of the first hospital of Jilin University from December 2018 to December 2019 were selected retrospectively. According to the treatment methods, they were divided into control group (n=45) and observation group (n=34). Patients in the control group received routine treatment according to the guidelines for cardiogenic shock after myocardial infarction, namely oxygen therapy, intensive care and correction of internal environment disorders. Give vasoactive drugs such as analgesia, sedation and pressor, and drugs to correct heart failure and arrhythmia. The representative drugs are dopamine, norepinephrine, etc. On the basis of the control group, patients in the observation group were given 5.2 g of Yiqi Fumai Lyophilized Injection and 250 mL of 5% glucose injection (if the patient''s blood glucose was high, it was changed to 250 mL of 0.9% sodium chloride injection). The intravenous drip speed was less than 20 drops/min, once a day for seven days. The mortality of the two groups at discharge was recorded, and the changes of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), lactic acid, leukocyte and albumin were compared between the two groups before and after treatment. The adverse reactions during the intravenous drip of Yiqi Fumai Lyophilized Injection and 1 h after treatment were observed. Results The mortality at discharge in the observation group was 38.2% and that in the control group was 75.6%. There was significant difference between the two groups (P<0.05). The improvement of SBP,DBP and lactate indexes in the survival patients in observation group were better than those in the control group (P<0.05). Compared with the control group, the improvement of HR, albumin and leukocyte in the survival patients of observation group had no significant difference (P>0.05). There was no adverse reaction in the observation group during the application of Yiqi Fumai Lyophilized Injection and 1 hour after the end. Conclusion The treatment of Yiqi Fumai Lyophilized Injection in patients with cardiogenic shock after myocardial infarction on the basis of routine treatment is effective, the clinical application is relatively safe, can improve the prognosis of patients, and has a certain clinical value.