目的 探討丹參川芎嗪注射液聯(lián)合替羅非班治療急性ST段抬高型心肌梗死(STEMI)的療效。方法 選取2013年3月-2015年12月在首都醫(yī)科大學(xué)附屬北京潞河醫(yī)院心血管內(nèi)科行PCI的STEMI患者120例,隨機(jī)分為對照組和治療組,每組各60例。對照組在PCI后30 min內(nèi)靜脈滴注注射用鹽酸替羅非班,起始劑量為3 μg/kg,而后以0.06 μg/(kg·min)微量靜脈滴入,1次/d。治療組在對照組治療基礎(chǔ)上靜脈滴注丹參川芎嗪注射液,15 mL加入5%葡萄糖溶液200 mL,3次/d。兩組均連續(xù)用藥6 d。觀察治療前后兩組患者血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脫氫酶(LDH)、血紅蛋白、血小板的變化。比較兩組心臟不良事件包括心源性死亡、心肌再梗死、再次靶血管血運(yùn)重建的發(fā)生情況。結(jié)果 治療后,兩組CK、CK-MB和LDH均顯著降低,同組治療前后差異有統(tǒng)計(jì)學(xué)意義(P<0.05);治療組降低的更顯著,兩組間比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。住院期間,對照組和治療組發(fā)生心臟不良事件的總發(fā)生率分別為13.33%、8.33%;術(shù)后45 d兩組的總發(fā)生率分別為10.00%、3.33%,兩組總發(fā)生率比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者血紅蛋白和血小板均沒有發(fā)生明顯變化。結(jié)論 丹參川芎嗪聯(lián)合替羅非班治療急性ST段抬高型心肌梗死可降低心肌梗死程度,降低不良事件發(fā)生率,且無嚴(yán)重不良反應(yīng)發(fā)生,具有一定的臨床推廣應(yīng)用價(jià)值。

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 3 μg/kg, and then 0.06 μg/(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.