目的 評價注射用益氣復(fù)脈（凍干）治療心肌梗死后心源性休克的臨床療效。方法 回顧性選取2018年12月—2019年12月就診于吉林大學(xué)第一醫(yī)院心內(nèi)科重癥監(jiān)護室的79例心源性休克患者為研究對象，根據(jù)治療方法分為對照組（n=45）和觀察組（n=34），對照組按照心肌梗死后心源性休克指南予以常規(guī)治療即氧療、重癥監(jiān)護、糾正內(nèi)環(huán)境紊亂，予以鎮(zhèn)痛、鎮(zhèn)靜、升壓等血管活性藥物及糾正心衰及心律失常藥物，代表藥物有多巴胺、去甲腎上腺素等；觀察組在對照組基礎(chǔ)上予以注射用益氣復(fù)脈（凍干）5.2 g加入5%葡萄糖注射液250 mL（若患者血糖高改為0.9%氯化鈉注射液250 mL）靜脈滴注，靜滴速度<20滴/min，1次/d，連用7 d。記錄兩組患者出院時死亡率，比較兩組治療前后心率（HR）、收縮壓（SBP）、舒張壓（DBP）、乳酸、白細胞及白蛋白等變化情況，觀察注射用益氣復(fù)脈（凍干）靜脈滴注期間及用藥后1 h不良反應(yīng)。結(jié)果 觀察組出院時死亡率為38.2%，對照組為75.6%，兩組差異有統(tǒng)計學(xué)意義（P<0.05）；觀察組SBP、DBP、乳酸指標改善情況優(yōu)于對照組，兩組差異有統(tǒng)計學(xué)意義（P<0.05）；觀察組存活患者中HR、白蛋白及白細胞改善情況與對照組比較差異無統(tǒng)計學(xué)意義（P>0.05）；觀察組在應(yīng)用益氣復(fù)脈（凍干）期間及結(jié)束后1 h未見不良反應(yīng)。結(jié)論 心肌梗死后心源性休克患者在常規(guī)治療基礎(chǔ)上采用益氣復(fù)脈（凍干）治療有效，臨床應(yīng)用相對安全，可改善患者預(yù)后，具有一定的臨床推廣價值。

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.

R972