果糖二磷酸钠治疗急性心肌梗死的临床研究

发布时间：2018-06-20 22:12

  本文选题：果糖二磷酸钠 + 急性心肌梗死　； 参考：《中国药房》2017年08期

【摘要】：目的:探讨果糖二磷酸钠对急性心肌梗死(AMI)患者心功能、心肌损伤标志物、缺血修饰白蛋白(IMA)、和肽素的影响及安全性。方法:采用回顾性研究方法,选择2014年2月-2015年4月在南阳市第二人民医院接受治疗的102例AMI患者的临床资料,按治疗方案不同分为观察组和对照组,各51例。两组患者均行基础治疗,并给予尿激酶静脉滴注+肝素静脉泵注+阿司匹林口服等对症治疗方案。观察组患者在此基础上联用注射用果糖二磷酸钠10 g静脉滴注,bid。两组患者均连续治疗7~10 d。记录两组患者治疗前后左室舒张末期内径(LVDd)、左室收缩末期内径(LVSd)、左室射血分数(LVEF)等心功能指标,心肌肌钙蛋白Ⅰ(cTnⅠ)、肌酸激酶同工酶(CK-MB)等心肌损伤标志物及IMA、和肽素等指标变化情况,心功能分级情况,以及不良反应和不良事件发生情况。结果:治疗前,两组患者上述指标比较,差异均无统计学意义(P0.05)。治疗后12、24 h,两组患者的LVDd、LVSd较治疗前显著缩短,LVEF、IMA水平较治疗前显著升高,CK-MB、和肽素水平较治疗前显著降低,且观察组患者的改善幅度均显著大于对照组同期,差异均有统计学意义(P0.05);两组患者的cTnⅠ水平较治疗前逐渐提升[观察组患者治疗后12 h与治疗前比较差异无统计学意义(P0.05)],但观察组患者的增幅显著小于对照组同期,差异均有统计学意义(P0.05)。治疗后24 h,观察组患者心功能Killip分级的Ⅰ~Ⅱ级率为96.1%,显著高于对照组的78.4%,差异有统计学意义(P0.05)。两组患者均未见严重的不良反应发生,不良反应发生率比较差异无统计学意义(P0.05);在不良事件方面,两组患者除死亡率比较差异无统计学意义(P0.05)外,观察组患者发生严重心律失常、再发心肌梗死、梗死后心绞痛等不良事件的例数及总发生率均显著少于或低于对照组,差异有统计学意义(P0.05)。结论:在常规对症治疗基础上联用果糖二磷酸钠治疗AMI,可有效提升心肌损伤标志物、IMA及和肽素水平,改善患者心功能,降低不良事件发生风险,从而提升预后质量。
[Abstract]:Aim: to investigate the effects and safety of fructose diphosphate on cardiac function, myocardial injury markers, ischemia modified albumin IMAN and peptide in acute myocardial infarction (AMI) patients. Methods: the clinical data of 102 AMI patients who were treated in the second people's Hospital of Nanyang City from February 2014 to April 2015 were retrospectively studied. The patients were divided into observation group (51 cases) and control group (51 cases) according to different treatment schemes. The patients in both groups were treated with basic therapy and urokinase intravenous infusion of heparin, aspirin, oral administration and other symptomatic treatments. The patients in the observation group were treated with 10 g fructose diphosphate intravenously. The patients in both groups were treated continuously for 7 to 10 days. Left ventricular end-diastolic diameter (LVDdN), left ventricular end-systolic diameter (LVSdN), left ventricular ejection fraction (LVVEF) and so on were recorded before and after treatment. Cardiac troponin 鈪，

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