中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2014年
2期
143-146
,共4页
组织型纤溶酶原激活物%谷胱甘肽%心肌梗死
組織型纖溶酶原激活物%穀胱甘肽%心肌梗死
조직형섬용매원격활물%곡광감태%심기경사
Tissue plasminogen activator%Glutathione%Myocardial infarction
目的 探讨瑞替普酶(rPA)联合还原型谷胱甘肽(GSH)治疗急性ST段抬高型心肌梗死(STEMI)的临床疗效. 方法 2010年2月至2013年2月本院收治的STEMI患者80例,根据收治顺序分为观察组与对照组,每组40例.在给予常规治疗的基础上,对照组给予rPA静脉注射,观察组给予rPA静脉注射+还原型GSH静脉滴注.对两组患者的血管再通率、心肌酶谱检测、心室结构与心功能以及主要心脏不良事件等进行比较. 结果 观察组治疗后的血管再通率为90.0％,与对照组(82.5％)比较,差异无统计学意义(P＞0.05)；治疗24 h后,观察组血肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白(cTn)I和T水平均低于对照组,差异有统计学意义(t=10.44、6.008、29.63,P＜0.05)；治疗1个月后,观察组的左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)均小于对照组,左心室射血分数(LVEF)高于对照组,差异均有统计学意义(t=4.543、5.605、4.652,P＜0.05)；观察组心源性休克、再梗死、心绞痛和心律失常的发生率均低于对照组,差异有统计学意义(x2=5.128、7.825、6.000、4.669,P＜0.05). 结论 rPA联合还原型GSH治疗STEMI具有疗效显著、安全可靠、并发症少等优点,值得临床推广.
目的 探討瑞替普酶(rPA)聯閤還原型穀胱甘肽(GSH)治療急性ST段抬高型心肌梗死(STEMI)的臨床療效. 方法 2010年2月至2013年2月本院收治的STEMI患者80例,根據收治順序分為觀察組與對照組,每組40例.在給予常規治療的基礎上,對照組給予rPA靜脈註射,觀察組給予rPA靜脈註射+還原型GSH靜脈滴註.對兩組患者的血管再通率、心肌酶譜檢測、心室結構與心功能以及主要心髒不良事件等進行比較. 結果 觀察組治療後的血管再通率為90.0％,與對照組(82.5％)比較,差異無統計學意義(P＞0.05)；治療24 h後,觀察組血肌痠激酶同工酶(CK-MB)、心肌肌鈣蛋白(cTn)I和T水平均低于對照組,差異有統計學意義(t=10.44、6.008、29.63,P＜0.05)；治療1箇月後,觀察組的左心室舒張末期內徑(LVEDd)、左心室收縮末期內徑(LVESd)均小于對照組,左心室射血分數(LVEF)高于對照組,差異均有統計學意義(t=4.543、5.605、4.652,P＜0.05)；觀察組心源性休剋、再梗死、心絞痛和心律失常的髮生率均低于對照組,差異有統計學意義(x2=5.128、7.825、6.000、4.669,P＜0.05). 結論 rPA聯閤還原型GSH治療STEMI具有療效顯著、安全可靠、併髮癥少等優點,值得臨床推廣.
목적 탐토서체보매(rPA)연합환원형곡광감태(GSH)치료급성ST단태고형심기경사(STEMI)적림상료효. 방법 2010년2월지2013년2월본원수치적STEMI환자80례,근거수치순서분위관찰조여대조조,매조40례.재급여상규치료적기출상,대조조급여rPA정맥주사,관찰조급여rPA정맥주사+환원형GSH정맥적주.대량조환자적혈관재통솔、심기매보검측、심실결구여심공능이급주요심장불량사건등진행비교. 결과 관찰조치료후적혈관재통솔위90.0％,여대조조(82.5％)비교,차이무통계학의의(P＞0.05)；치료24 h후,관찰조혈기산격매동공매(CK-MB)、심기기개단백(cTn)I화T수평균저우대조조,차이유통계학의의(t=10.44、6.008、29.63,P＜0.05)；치료1개월후,관찰조적좌심실서장말기내경(LVEDd)、좌심실수축말기내경(LVESd)균소우대조조,좌심실사혈분수(LVEF)고우대조조,차이균유통계학의의(t=4.543、5.605、4.652,P＜0.05)；관찰조심원성휴극、재경사、심교통화심률실상적발생솔균저우대조조,차이유통계학의의(x2=5.128、7.825、6.000、4.669,P＜0.05). 결론 rPA연합환원형GSH치료STEMI구유료효현저、안전가고、병발증소등우점,치득림상추엄.
Objective To explore the clinical efficacy of reteplase(rPA) combined with reduced glutathione(GSH) for the treatment of acute ST-segment elevation myocardial infarction(STEMI).Methods 80 patients with STEMI received in our hospital from Feb 2010 to Feb 2013 were divided into observation group and control group according to the treatment type,with 40 cases in each group.The control group was treated with rPA for intravenous injection on the basis of conventional treatment,and the observation group was added reduced GSH intravenously on the basis of control group.The recanalization rate,myocardial enzymes levels,ventricular structure and function of the heart and major adverse cardiac events in the two groups of patients were compared.Results There canalization rate in observation group was 90％ after treatment,compared with the control group (82.5％) which showed no significant difference as compared with the control group(90％ vs.82％,P＞0.05).Serum creatine kinase-MB fraction(CK-MB),cardiac troponin(cTn) I and TcTnI and cTnT levels in observation group after 24h were significantly lower in observation group than in the control group after 24 h of treatment(t=10.44,6.008,29.63,respectively,all P＜0.05); left ventricular end diastolic diameter (LVEDd) and left ventricular end systolic diameter (LVESd) in observation group were significantly shorter and left ventricular ejection fraction (LVEF) was significantly higher in observation group than in the control group after 1 month of treatment (t =4.543,5.605,4.652,respectively,all P＜0.05).The incidence of cardiogenic shock,reinfarction,angina and arrhythmia in observation group were significantly lower in observation group than in the control group(x2=5.128,7.825,6.000,4.669,respectively,all P＜0.05).Conclusions rPA combined with reduced GSH for the treatment of STEMI had is significantly effective,safe and reliable,has fewer complications,and is worthy of clinical promotion.
