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[摘要]
目的 探討燈盞花素注射液聯(lián)合鹽酸替羅非班氯化鈉注射液治療急性心肌梗死的臨床療效。方法 選取2016年9月-2017年9月在濱州醫(yī)學(xué)院煙臺附屬醫(yī)院進(jìn)行治療的急性心肌梗死患者86例為研究對象,采用計(jì)算機(jī)將患者隨機(jī)分為對照組和治療組,每組各43例。對照組給予鹽酸替羅非班氯化鈉注射液,初始以10 μg/kg進(jìn)行靜脈推注,3 min內(nèi)完成,之后以0.15 μg/(kg·min)持續(xù)性靜脈泵入。治療組在對照組治療的基礎(chǔ)上靜脈滴注燈盞花素注射液,20 mg加入到5%葡萄糖注射液250 mL中,1次/d。兩組患者均連續(xù)治療2周。觀察兩組的臨床療效,比較兩組的心功能指標(biāo)、血清學(xué)指標(biāo)、心絞痛發(fā)作次數(shù)。結(jié)果 治療后,對照組和治療組的總有效率分別為79.07%、95.35%,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組左心室舒張末期內(nèi)徑(LVEDD)、左心室收縮末期內(nèi)徑(LVESD)、左心室收縮末期容積(LVESV)均顯著下降,左心室射血分?jǐn)?shù)(LVEF)均顯著升高,同組治療前后比較差異有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些心功能指標(biāo)的改善程度明顯優(yōu)于對照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組血清超敏C反應(yīng)蛋白(hs-CRP)、N末端心房利鈉肽(NT-proBNP)、生長分化因子-15(GDF-15)水平均顯著降低,心肌營養(yǎng)素-1(CT-1)、白細(xì)胞介素-10(IL-10)水平均顯著升高,同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些血清學(xué)指標(biāo)的改善程度明顯優(yōu)于對照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組心絞痛發(fā)作次數(shù)顯著減少,同組治療前后比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組心絞痛發(fā)作次數(shù)明顯優(yōu)少于對照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。結(jié)論 燈盞花素注射液聯(lián)合鹽酸替羅非班氯化鈉注射液治療急性心肌梗死具有較好的臨床療效,可改善臨床癥狀和心功能,降低機(jī)體炎癥反應(yīng),具有一定的臨床推廣應(yīng)用價(jià)值。
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[Abstract]
Objective To investigate the clinical efficacy of Breviscapine Injection combined with Tirofiban Hydrochloride Sodium Chloride Injection in treatment of acute myocardial infarction. Methods Patients (86 cases) with acute myocardial infarction in Yantai Affiliated Hospital of Binzhou Medical University from September 2016 to September 2017 were randomly divided into control and treatment groups, and each group had 43 cases. Patients in the control group were given Tirofiban Hydrochloride Sodium Chloride Injection, initial intravenous injection with 10 μg/kg, and completed within 3 min, then continuous venous pumped with 0.15 μg/(kg·min). Patients in the treatment group were iv administered with Breviscapine Injection on the basis of the control group, 20 mg added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacies were evaluated, and cardiac function indexes, serological indexes, and the frequency of angina pectoris in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 79.07% and 95.35%, respectively, and there was difference between two groups (P < 0.05). After treatment, LVEDD, LVESD, and LVESV in two groups were significantly decreased, but the LVEF in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And the cardiac function indexes, in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). After treatment, the levels of hs-CRP, NT-proBNP, and GDF-15 in two groups were significantly decreased, but the levels of CT-1 and IL-10 in two groups were significantly increased, and the difference was statistically significant in the same group (P < 0.05). And 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). After treatment, the frequencies of angina pectoris in two groups were significantly decreased, and the difference was statistically significant in the same group (P < 0.05). And the frequency of angina pectoris in the treatment group was significantly lower than those in the control group, with significant difference between two groups (P < 0.05). Conclusion Breviscapine Injection combined with Tirofiban Hydrochloride Sodium Chloride Injection has clinical curative effect in treatment of acute myocardial infarction, can improve clinical symptoms and cardiac function, decrease the inflammatory response, which has a certain clinical application value.
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