阿昔单抗联合低分子肝素在急性心肌梗死PCI缺血后适应中的应用

发布时间：2018-05-21 14:48

本文选题：急性心肌梗死 + 缺血后适应　；参考：《山东医药》2016年22期

【摘要】：目的观察低分子肝素联合阿昔单抗在急性心肌梗死(AMI)PCI缺血后适应中的应用效果,并观察其安全性。方法将108例缺血后适应AMI患者随机分为观察组和对照组各54例,对照组常规应用低分子肝素抗凝治疗,观察组在此基础上加用阿昔单抗治疗。比较两组血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、心脏超声参数、心脏不良事件和出血事件发生率。结果两组治疗3 d后血清CK及CK-MB均较治疗前降低,且观察组较对照组降低(P均0.05)。治疗3个月后,两组左心室舒张期末容积指数(LVEDVI)、左心室收缩期末容积指数(LVESVI)及室壁运动计分(WMSI)与治疗前比较均降低(P均0.05),而左心室射血分数(LVEF)明显升高(P均0.05);与对照组比较,观察组LVESVI、WMSI降低,LVEF升高(P均0.05)。观察组心脏不良事件发生率低于对照组(P0.05)。两组出血事件发生率比较差异无统计学意义(P0.05)。结论阿昔单抗联合低分子肝素能够有效改善缺血后适应AMI患者的心脏功能,降低心脏事件的发生率,且不增加出血风险。
[Abstract]:Objective to observe the efficacy and safety of low molecular weight heparin (LMWH) combined with acicumab in the treatment of acute myocardial infarction (AMI) after PCI. Methods one hundred and eight patients with ischemic adaptation to AMI were randomly divided into two groups: observation group (n = 54) and control group (n = 54). The control group was treated with low-molecular-weight heparin (LMWH) anticoagulant therapy. Serum creatine kinase (CK), creatine kinase isoenzyme (CK-MBN), cardiac ultrasound parameters, adverse cardiac events and the incidence of bleeding events were compared between the two groups. Results after 3 days of treatment, serum CK and CK-MB in both groups were lower than those before treatment, and the levels of serum CK and CK-MB in the observation group were lower than those in the control group (P < 0.05). After 3 months of treatment, the left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI) and wall motion score (WMSI) in both groups decreased by 0.05, while left ventricular ejection fraction (LVEFV) increased significantly (P = 0.05), compared with control group, the left ventricular end-diastolic volume index (LVEDVI), left ventricular end-systolic volume index (LVESVI) and wall motion score (WMSI) were significantly higher than those before treatment (P < 0.05). In the observation group, LVESVI WMSI decreased LVEF and increased P 0.05. The incidence of adverse cardiac events in the observation group was lower than that in the control group (P 0.05). There was no significant difference in the incidence of hemorrhage events between the two groups (P 0.05). Conclusion Axiumab combined with low molecular weight heparin (LMWH) can effectively improve the cardiac function and reduce the incidence of cardiac events in patients with AMI after ischemia without increasing the risk of bleeding.
【作者单位】：黄骅市人民医院;
【基金】：河北省沧州市科技局科技支撑计划项目(141302084)
【分类号】：R542.22

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