灯盏花素注射液联合阿替普酶治疗急性心肌梗死的临床研究
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摘要
目的探讨灯盏花素注射液联合注射用阿替普酶治疗急性心肌梗死的临床疗效。方法选取2017年3月—2018年6月天津市宁河区医院收治的急性心肌梗死患者92例为研究对象,按照随机数字表法分为对照组和治疗组,每组各46例。对照组静脉注射注射用阿替普酶100 mg,先注射20 mg,30 min后注射30 mg,60 min后注射30 mg,最后20 mg在90 min内静脉滴注完毕。治疗组在对照组治疗的基础上静脉滴注灯盏花素注射液,10 mg加入到10%葡萄糖溶液500 mL中,1次/d。两组患者均连续治疗14d。观察两组的临床疗效,比较两组的白细胞介素-6(IL-6)、白细胞介素-1β(IL-1β)、肌酸激酶同工酶(CK-MB)、肌钙蛋白T(cTnT)、左室射血分数(EF)、左室舒张功能比值(E/A)。结果治疗后,对照组和治疗组的总有效率分别为76.09%、91.30%,两组比较差异有统计学意义(P<0.05)。治疗后,两组IL-6、IL-1β水平较治疗前明显降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗组IL-6、IL-1β水平均明显低于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组CK-MB、cTnT水平均显著降低,同组治疗前后比较差异具有统计学意义(P<0.05);治疗后治疗组的CK-MB、cTnT水平均明显低于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组EF、E/A值较治疗前升高,同组治疗前后比较差异有统计学意义(P<0.05);治疗后治疗组EF、E/A值均高于对照组,两组比较差异具有统计学意义(P<0.05)。结论灯盏花素注射液联合注射用阿替普酶治疗急性心肌梗死的疗效确切,能降低炎症反应,减轻心肌细胞损伤,改善心肌功能,具有一定的临床推广应用价值。
Objective To investigate the clinical efficacy of Breviscapine Injection combined with Alteplase for injection in treatment of acute myocardial infarction. Methods Patients(92 cases) with acute myocardial infarction in Tianjin Ninghe District Hospital from March 2017 to June 2018 were randomly divided into control and treatment groups, and each group had 46 cases. Patients in the control group were iv administered with Alteplase for injection 100 mg, the first 20 mg, 30 mg after 30 min, and 30 mg after 60 min,the last 20 mg within 90 min. Patients in the treatment group were iv administered with Breviscapine Injection on the basis of the control group, 10 mg added into 10% glucose solution 500 mL, once daily. Patients in two groups were treated for 14 d. After treatment,the clinical efficacies were evaluated, and IL-6, IL-1β, CK-MB, cTnT, EF, and E/A in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.09% and 91.30%, respectively, and there was difference between two groups(P < 0.05). After treatment, the levels of IL-6 and IL-1β in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the levels of CK-MB and cTnT in two groups were significantly decreased, 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, EF and E/A 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 higher than those in the control group, with significant difference between two groups(P < 0.05). Conclusion Breviscapine Injection combined with Alteplase for injection has clinical curative effect in treatment of acute myocardial infarction, can reduce inflammation and myocardial cell damage, and improve myocardial function, which has a certain clinical application value.
Objective To investigate the clinical efficacy of Breviscapine Injection combined with Alteplase for injection in treatment of acute myocardial infarction. Methods Patients(92 cases) with acute myocardial infarction in Tianjin Ninghe District Hospital from March 2017 to June 2018 were randomly divided into control and treatment groups, and each group had 46 cases. Patients in the control group were iv administered with Alteplase for injection 100 mg, the first 20 mg, 30 mg after 30 min, and 30 mg after 60 min,the last 20 mg within 90 min. Patients in the treatment group were iv administered with Breviscapine Injection on the basis of the control group, 10 mg added into 10% glucose solution 500 mL, once daily. Patients in two groups were treated for 14 d. After treatment,the clinical efficacies were evaluated, and IL-6, IL-1β, CK-MB, cTnT, EF, and E/A in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.09% and 91.30%, respectively, and there was difference between two groups(P < 0.05). After treatment, the levels of IL-6 and IL-1β in two groups were significantly decreased, and the difference was statistically significant in the same group(P < 0.05). And the observational indexes in the treatment group were significantly lower than those in the control group, with significant difference between two groups(P < 0.05). After treatment, the levels of CK-MB and cTnT in two groups were significantly decreased, 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, EF and E/A 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 higher than those in the control group, with significant difference between two groups(P < 0.05). Conclusion Breviscapine Injection combined with Alteplase for injection has clinical curative effect in treatment of acute myocardial infarction, can reduce inflammation and myocardial cell damage, and improve myocardial function, which has a certain clinical application value.
引文
[1]苏懿,王磊,张敏州.急性心肌梗死的流行病学研究进展[J].中西医结合心脑血管病杂志,2012,10(4):467-469.
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[3]杨丽华,郝信磊.灯盏花素注射液联合替罗非班治疗急性心肌梗死的临床研究[J].现代药物与临床,2018,33(4):767-771.
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[7]耿二冬,秦宇红.阿替普酶静脉溶栓对急性心肌梗死患者心肌损伤标志物及心功能的影响[J].广东医学,2017,38(s1):256-258.
[8]王娓娓,张红苗,王琳,等.灯盏花素通过上调miR-140表达对心肌缺血再灌注损伤发挥保护作用[J].天然产物研究与开发,2017,29(2):299-303.
[9]任琢琢.灯盏花素注射液对急性ST段抬高性心肌梗死急诊PCI术后心力衰竭患者神经内分泌激素、血清MMP-9及MPO的影响[J].现代中西医结合杂志,2016,25(35):3899-3902.
[10]李玉茹.血清CRP和IL-6水平对急性心肌梗死患者支架内血栓形成的预测价值[J].检验医学与临床,2017,14(17):2534-2536.
[11]向满林,梁运来,谢旭林,等.急性冠脉综合征患者血清hs-CRP、IL-1β和Lp-PLA2检测的临床意义[J].中国医师杂志,2017,19(1):66-68.
[12]杨建峰,魏经汉,董建增,等.慢性心力衰竭患者血清sFas、白细胞介素-1β水平及临床意义[J].中国综合临床,2002,18(1):20-21.
[13]周阳贞,李艳.急性心肌梗死患者PCI手术前后CRP、NT-proBNP、CK-MB、cTnT水平测定及临床意义[J].海南医学院学报,2016,22(13):1357-1360.
[14]黄晓梅.超声心动图联合心电图QRS碎裂波诊断心肌梗死的临床价值[J].河北医学,2016,22(5):803-806.
[2]陈泽江,黄修献.阿替普酶与尿激酶溶栓治疗急性心肌梗死疗效观察[J].现代中西医结合杂志,2016,25(10):1087-1089.
[3]杨丽华,郝信磊.灯盏花素注射液联合替罗非班治疗急性心肌梗死的临床研究[J].现代药物与临床,2018,33(4):767-771.
[4]中华医学会心血管病学分会.急性心肌梗死诊断和治疗指南[J].中华心血管病杂志,2001,29(12):710-725.
[5]孙传兴.临床疾病诊断依据治愈好转标准[M].第2版.北京:人民军医出版社,1998:16-17.
[6]刘辉,张燕,张少利,等.老年非ST段抬高型急性心肌梗死患者临床特征及预后影响因素[J].山东医药,2016,56(11):41-43.
[7]耿二冬,秦宇红.阿替普酶静脉溶栓对急性心肌梗死患者心肌损伤标志物及心功能的影响[J].广东医学,2017,38(s1):256-258.
[8]王娓娓,张红苗,王琳,等.灯盏花素通过上调miR-140表达对心肌缺血再灌注损伤发挥保护作用[J].天然产物研究与开发,2017,29(2):299-303.
[9]任琢琢.灯盏花素注射液对急性ST段抬高性心肌梗死急诊PCI术后心力衰竭患者神经内分泌激素、血清MMP-9及MPO的影响[J].现代中西医结合杂志,2016,25(35):3899-3902.
[10]李玉茹.血清CRP和IL-6水平对急性心肌梗死患者支架内血栓形成的预测价值[J].检验医学与临床,2017,14(17):2534-2536.
[11]向满林,梁运来,谢旭林,等.急性冠脉综合征患者血清hs-CRP、IL-1β和Lp-PLA2检测的临床意义[J].中国医师杂志,2017,19(1):66-68.
[12]杨建峰,魏经汉,董建增,等.慢性心力衰竭患者血清sFas、白细胞介素-1β水平及临床意义[J].中国综合临床,2002,18(1):20-21.
[13]周阳贞,李艳.急性心肌梗死患者PCI手术前后CRP、NT-proBNP、CK-MB、cTnT水平测定及临床意义[J].海南医学院学报,2016,22(13):1357-1360.
[14]黄晓梅.超声心动图联合心电图QRS碎裂波诊断心肌梗死的临床价值[J].河北医学,2016,22(5):803-806.