CAJ | 학술논문

目的：探讨新活素治疗急诊PCI术后BNP水平较高的急性前壁心肌梗死患者的疗效和安全性。方法将大连医科大学附属第一医院2011年8月-2012年8月收治的128例急性前壁ST段抬高性心肌梗死患者随机分为对照组（64例）和新活素组（64例）。对照组患者给予抗凝、抗血小板、他汀类、β受体阻滞剂、硝酸酯类药物和血管紧张素转化酶抑制剂（ ACEI）或血管紧张素受体拮抗剂（ ARB）及利尿剂等常规治疗，新活素组患者在常规治疗的基础上加用新活素（1～2 min内匀速静脉注射负荷量1．5μg/kg，然后以0．01μg/（kg· min）静脉匀速泵入持续72 h）。随访6个月，观察各组患者的疗效和安全性。结果与对照组比较，新活素组住院期间急性左心衰发生率（心功能≥Killip3级）较低（9．38％vs 21．88％，P＜0．05），随访6个月时BNP较低（98．7±41．2 vs 465．4±46．8， P＜0．05）、6 min步行距离较长[（576．0±82．5） m vs （494．0±74．1） m，P＜0．05]、左室舒张末径较小[（50．5±3．8）mm vs（59．3±4．1）mm， P＜0．05]，左室射血分数较高[（54．7±16．9）％ vs （46．2±18．6）％， P＜0．05]，而住院期间严重低血压（＜90/60 mmHg）的发生率两组相当。结论新活素治疗能显著改善急诊PCI术后BNP水平较高的急性前壁ST段抬高性心肌梗死患者的心功能。
목적：탐토신활소치료급진PCI술후BNP수평교고적급성전벽심기경사환자적료효화안전성。방법장대련의과대학부속제일의원2011년8월-2012년8월수치적128례급성전벽ST단태고성심기경사환자수궤분위대조조（64례）화신활소조（64례）。대조조환자급여항응、항혈소판、타정류、β수체조체제、초산지류약물화혈관긴장소전화매억제제（ ACEI）혹혈관긴장소수체길항제（ ARB）급이뇨제등상규치료，신활소조환자재상규치료적기출상가용신활소（1～2 min내균속정맥주사부하량1．5μg/kg，연후이0．01μg/（kg· min）정맥균속빙입지속72 h）。수방6개월，관찰각조환자적료효화안전성。결과여대조조비교，신활소조주원기간급성좌심쇠발생솔（심공능≥Killip3급）교저（9．38％vs 21．88％，P＜0．05），수방6개월시BNP교저（98．7±41．2 vs 465．4±46．8， P＜0．05）、6 min보행거리교장[（576．0±82．5） m vs （494．0±74．1） m，P＜0．05]、좌실서장말경교소[（50．5±3．8）mm vs（59．3±4．1）mm， P＜0．05]，좌실사혈분수교고[（54．7±16．9）％ vs （46．2±18．6）％， P＜0．05]，이주원기간엄중저혈압（＜90/60 mmHg）적발생솔량조상당。결론신활소치료능현저개선급진PCI술후BNP수평교고적급성전벽ST단태고성심기경사환자적심공능。
Objective To observe the clinical efficacy and safety of Xinhuosu for patients of acute anterior myocardial in -farction with BNP level higher after successful primary percutaneous coronary intervention ( PCI ) .Methods 128 patients with acute anterior ST-elevation myocardial infarction had all undergone successful primary PCI .Patients were randomly assigned to 2 groups ( control and Xinhuosu groups ) , and given Xinhuosu or saline after PCI besides conventional therapy . All the patients were followed up for 6 months.The clinical efficacy and safety of both groups were observed .Results In the Xinhuosu group, the rate of acute left heart failure during the hospital stay was lower (9.38%vs 21.88%,P<0.05), and after follow-up of 6 months, BNP was lower (98.7 ±41.2 vs 465.4 ±46.8, P<0.05),Walking distance for 6 minutes was longer, (576 ±82.5) m vs (494 ±74.1) m, P<0.05, Left ventricular end -diastolic diameter (LVEDD) was low-er,(50.5 ±3.8) mm vs (59.3 ±4.1) mm, P<0.05, Left ventricular ejection fraction (LVEF) was higher,(54.7 ± 16.9)%vs (46.2 ±18.6)%, P<0.05, while severe hypotension ( <90/60 mm Hg) during the hospital stay was not higher (46.9%vs 39.1%, P>0.05), comparing with those in control group .Conclusion Xinhuosu can greatly improve the cardiac function of the patients of acute anterior myocardial infarction with BNP level higher after primary PCI .