目的 探討生脈注射液聯(lián)合阿替普酶治療急性心肌梗死的臨床療效。方法 選取2013年3月-2015年3月在石家莊市第二醫(yī)院急診科接受治療的急性心肌梗死患者92例,按照治療方法的不同分為對照組和治療組,每組各46例。對照組給予注射用阿替普酶,100mg在90min內(nèi)滴完,首先給予15mg靜脈推注,隨后在30min內(nèi)靜脈滴注50mg,最后35mg在60min內(nèi)滴完,1次/d。治療組在對照組治療的基礎(chǔ)上靜脈滴注生脈注射液,60mL加入生理鹽水250mL,1次/d。兩組患者均連續(xù)治療14d。觀察兩組的臨床療效和冠狀動脈再通情況,同時比較治療前后炎癥因子包括血漿腦鈉肽(BNP)、腫瘤壞死因子α(TNF-α)、白細(xì)胞介素6(IL-6)及高敏C反應(yīng)蛋白(hs-CRP),血液流變學(xué)指標(biāo)包括血細(xì)胞比容(HCT)、紅細(xì)胞聚集指數(shù)(RF)、全血高切黏度(HS)、纖維蛋白原(FIB)等指標(biāo)的變化情況。結(jié)果 治療后,對照組和治療組的總有效率分別為80.43%、95.65%,冠脈再通率分別為65.22%、84.78%,兩組比較差異具有統(tǒng)計學(xué)意義(P<0.05)。治療后,兩組患者IL-6、BNP、TNF-α、hs-CRP、HCT、FIB、RF、HS均顯著降低,同組治療前后差異具有統(tǒng)計學(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,兩組比較差異有統(tǒng)計學(xué)意義(P<0.05)。結(jié)論 生脈注射液聯(lián)合阿替普酶治療急性心肌梗死具有較好的臨床療效,可明顯減輕炎性反應(yīng),有利于改善血流動力學(xué),具有一定的臨床推廣應(yīng)用價值。

Objective To investigate the clinical effect of Shengmai Injection combined with alteplase in treatment of acute myocardial infarction. Methods Patients (92 cases) with acute myocardial infarction in Department of Emergency of the Second Hospital of Shijiazhuang from March 2013 to March 2015 were enrolled in this study. According to the different treatment plans, patients were divided into control group (46 cases) and treatment group (46 cases). The patients in the control group were given Alteplase for injection, dropped down 100 mg in 90 min. First they were iv administered with Alteplase for injection 15 mg, then intravenous drip 50 mg within 30 min, the last 35 mg drops down in 60 min, once daily. The patients in the treatment group were iv administered with Shengmai Injection on the basis of the control group, 60 mL added into normal saline 250 mL, once daily. The patients in two groups were treated for 14 d. After treatment, the clinical efficacies and coronary artery recanalization were evaluated, and the changes of BNP, TNF-α, IL-6, hs-CRP, HCT, RF, HS, and FIB in two groups were compared before and after treatment. Results After treatment, the efficacies in the control and treatment groups were 80.43% and 95.65%, and the rate of coronary artery recanalization in two groups were 65.22% and 84.78%, respectively, and there were differences between two groups (P < 0.05). After treatment, IL-6, BNP, TNF-α, hs-CRP, HCT, FIB, RF, and HS 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). Conclusion Shengmai Injection combined with alteplase has clinical curative effect in treatment of acute myocardial infarction, and can significantly reduce inflammatory reaction, also can improve blood flow dynamics, which has a certain clinical application value.