目的 觀察丹紅注射液聯(lián)合鹽酸替羅非班治療急性冠狀動脈綜合征的臨床療效。方法 選取2013年9月—2015年9月延安大學(xué)咸陽醫(yī)院心內(nèi)科收治的急性冠狀動脈綜合征患者86例,按照治療方案不同將患者分為對照組和治療組,每組各43例。對照組在基礎(chǔ)治療的基礎(chǔ)上靜脈滴注注射用鹽酸替羅非班,起始劑量是0.4 μg/(kg·min),30 min內(nèi)注射完畢,靜脈維持量為0.1 μg/(kg·min),維持24 h,并經(jīng)急診行PCI術(shù)。治療組在對照組治療的基礎(chǔ)上靜脈滴注丹紅注射液,40 mL加入5%葡萄糖注射液100 mL稀釋后緩慢滴注,1次/d。兩組患者均連續(xù)治療14 d。觀察兩組的臨床療效,同時(shí)比較兩組左心射血分?jǐn)?shù)(LVEF)、左室舒張末期內(nèi)徑(LVEDD)和左室收縮末期內(nèi)徑(LVESD)的變化。觀察兩組ST段回落情況和出血情況,比較兩組再發(fā)心絞痛、新發(fā)心肌梗死、頑固性心肌缺血等主要不良心血管事件的發(fā)生情況。結(jié)果 治療后,對照組和治療組的總有效率分別為76.74%、93.02%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者LVEF、LVEDD、LVESD均顯著升高,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的改善程度優(yōu)于對照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。對照組ST段回落率為65.12%,治療組為83.72%,兩組比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05);對照組和治療組出血發(fā)生率分別為13.95%、11.63%,兩組比較差異無統(tǒng)計(jì)學(xué)意義。兩組不良心血管事件總發(fā)生率分別為13.95%、2.33%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 丹紅注射液聯(lián)合鹽酸替羅非班治療急性冠狀動脈綜合征療效較好,有利于心功能的改善,能夠降低心臟不良事件的發(fā)生率,具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the clinical effect of Danhong Injection combined with tirofiban hydrochloride in treatment acute coronary syndrome. Methods Patients (86 cases) with acute coronary syndrome were enrolled in this study from September 2013 to September 2015. According to the different treatment plan, patients were divided into treatment group (43 cases) and control group (43 cases). The patients in the control group were iv administered with Tirofiban Hydrochloride for injection on the basis of foundation treatment, and the starting dosage was 0.4 μg/(kg·min) in 30 min, and the maintain dosage of iv was 0.1 μg/(kg·min) for 24 h. They were administered with emergency PCI. The patients in the treatment group were po administered with Danhong Injection on the basis of control group, 40 mL Danhong Injection added into 100 mL 5% Glucose Injection, once daily. The patients in two groups were treated for 14 d. After treatment, the clinical efficacy were evaluated, and the changes of LVEF, LVEDD, and LVESD in two groups were compared. The situations of ST segment decline and bleeding in two groups were observed. The occurrences of major adverse cardiac events such as recurrence angina pectoris, new myocardial infarction, and stubborn heart deficiency in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.74% and 93.02%, respectively, and there were differences between two groups (P < 0.05). After treatment, LVEF, LVEDD, and LVESD in two groups were significantly elevated, 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). The ST segment fell back rate in the control group was 65.12%, and that in the treatment groups was 83.72%, with significant difference between two groups (P < 0.05). The incidences of bleeding in the control and treatment group were 13.95% and 11.63%, respectively, and there was no statistically significant difference between two groups. The incidence rates of adverse cardiovascular events in two groups were 13.95% and 2.33%, respectively, with significant difference between two groups (P < 0.05). Conclusion Danhong Injection combined with tirofiban hydrochloride has clinical curative effect in treatment acute coronary syndrome, and can improve heart function, and can reduce the incidence of cardiac adverse events, which has a certain clinical application value.