远隔器官后适应联合依达拉奉对急性心肌梗死患者心肌缺血再灌注损伤作用的研究

发布时间：2018-03-26 19:27

  本文选题：冠心病　切入点：急性心肌梗死　出处：《重庆医科大学学报》2016年09期

【摘要】：目的:探讨远隔器官后适应联合应用依达拉奉对急性心肌梗死患者心肌缺血再灌注损伤的作用。方法:选取2013年01月至2014年12月我院收治的急性心肌梗死患者144例,随机分为I/R组(静脉溶栓治疗)、RPOC组(静脉溶栓治疗+远隔器官后适应治疗)、E组(静脉溶栓+依达拉奉注射液静脉点滴)、ER组(静脉溶栓+远隔器官后适应+依达拉奉注射液静脉点滴),每组36例,分析各组患者肌酸激酶同工酶(creatine kinase isoenzymes,CKm B)及肌钙蛋白(cardiac troponinⅠ,c Tn I)分泌峰值及其动态变化,同时比较各组患者溶栓治疗后超声心动图指标,治疗后进行随访,观察不良事件发生情况。结果:CKm B、c Tn I峰值在I/R组、E组、RPOC组、ER组患者中依次降低,组间差异均具有统计学意义(P0.05);与I/R组比较,E组、EROC组、ER组患者左室舒张末内径(left ventricular enddiastolic,LVED)、计算室壁节段运动指数(wall motion score index,WMSI)均明显降低,左室射血分数(left ventricular ejection fractions,LVEF)%明显升高(P0.05);ER组患者LVED、WMSI均明显低于E组和RPOC组(P0.05),LVEF%明显高于E组和RPOC组(P0.05),WMSI明显低于E组(P0.05),但与RPOC组比较差异无统计学意义(P0.05);4组患者治疗后均随访3个月,随访期间均无失访和死亡病例,E组、EROC组、ER组再梗死、脑卒中、梗死后心绞痛、心力衰竭等不良事件发生率均明显低于I/R组(P0.05),但3组间比较,差异无统计学意义(P0.05)。结论:远隔器官后适应及依达拉奉的应用都能显著减少CKm B和c Tn I的释放,减轻急性心肌梗死后心室重塑,改善室壁运动,从而减轻心肌再灌注的损伤,改善预后。
[Abstract]:Objective: to investigate the effect of combined use of Edaravone on myocardial ischemia-reperfusion injury in patients with acute myocardial infarction. Methods: 144 patients with acute myocardial infarction admitted to our hospital from January 2013 to December 2014 were selected. I / R group (intravenous thrombolytic therapy) RPOC group (intravenous thrombolytic therapy for distal organ adaptation therapy) E group (intravenous thrombolytic Edaravone injection intravenous drip of ER group (intravenous thrombolytic distal organ adaptation Edara group). 36 patients in each group were treated by intravenous drip. The peak and dynamic changes of creatine kinase isoenzymers CKm B (creatine kinase isoenzymers CKm B) and cardiac cardiac troponin 鈪，

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