CAJ | 학술논문

目的：观察参麦注射液联合尿激酶溶栓治疗急性前壁心肌梗死(AMI)患者的疗效，并探讨其对患者的心功能等相关指标的影响。方法将我院收治的68例急性心肌梗死患者随机分为观察组和对照组各34例，对照组采用常规的西药(阿司匹林、吗啡、尿激酶、低分子肝素等)进行治疗，观察组则在对照组治疗的基础上加用静脉滴注参麦注射液治疗，比较两组患者治疗后的溶栓效果、心功能、缺血修饰性蛋白(IMA)、肌酸激酶同工酶(CK-MB)、脑钠肽(BNP)、超氧化物歧化酶(SOD)活性及丙二醛(MDA)的水平变化。结果两组患者经溶栓治疗后，其胸痛缓解、ST段回降、心肌酶峰值提前、再通率提高，两组比较差异均无统计学意义(P>0.05)，但在心律失常发生率方面比较，观察组明显低于对照组，差异具有统计学意义(P<0.05)；两组治疗前后各组内IMA、CK-MB、BNP、SOD、MDA进行比较，观察组的IMA、CK-MB、BNP、SOD、MDA均呈现不同程度的下降或者上升，差异具有统计学意义(P<0.05)；对照组仅IMA、CK-MB、BNP与治疗前差异具有统计学意义(P<0.05)；治疗后两组间BNP、SOD、MDA水平比较差异均具有统计学意义(P<0.05)；但两组的左室舒张末内径、射血分数比较差异均无统计学意义(P>0.05)；两组治疗后的心力衰竭、休克、死亡发生率比较差异也均无统计学意义(P>0.05)，但心绞痛发生率差异具有统计学意义(P<0.05)。结论常规溶栓治疗基础上加用参麦注射液有利于减少溶栓治疗后的并发症，改善心肌酶指标，改善预后。
목적：관찰삼맥주사액연합뇨격매용전치료급성전벽심기경사(AMI)환자적료효，병탐토기대환자적심공능등상관지표적영향。방법장아원수치적68례급성심기경사환자수궤분위관찰조화대조조각34례，대조조채용상규적서약(아사필림、마배、뇨격매、저분자간소등)진행치료，관찰조칙재대조조치료적기출상가용정맥적주삼맥주사액치료，비교량조환자치료후적용전효과、심공능、결혈수식성단백(IMA)、기산격매동공매(CK-MB)、뇌납태(BNP)、초양화물기화매(SOD)활성급병이철(MDA)적수평변화。결과량조환자경용전치료후，기흉통완해、ST단회강、심기매봉치제전、재통솔제고，량조비교차이균무통계학의의(P>0.05)，단재심률실상발생솔방면비교，관찰조명현저우대조조，차이구유통계학의의(P<0.05)；량조치료전후각조내IMA、CK-MB、BNP、SOD、MDA진행비교，관찰조적IMA、CK-MB、BNP、SOD、MDA균정현불동정도적하강혹자상승，차이구유통계학의의(P<0.05)；대조조부IMA、CK-MB、BNP여치료전차이구유통계학의의(P<0.05)；치료후량조간BNP、SOD、MDA수평비교차이균구유통계학의의(P<0.05)；단량조적좌실서장말내경、사혈분수비교차이균무통계학의의(P>0.05)；량조치료후적심력쇠갈、휴극、사망발생솔비교차이야균무통계학의의(P>0.05)，단심교통발생솔차이구유통계학의의(P<0.05)。결론상규용전치료기출상가용삼맥주사액유리우감소용전치료후적병발증，개선심기매지표，개선예후。
Objective To observe the effect of ginseng injection with urokinase thrombolysis therapy in acute anterior wall myocardial infarction (AMI) patients, and to discuss its impact on cardiac function. Methods Sixty-eight patients with acute myocardial infarction in our hospital were selected, and randomly divided into observation group and control group with 34 cases in each group. The control group was treated with routine method (aspirin, morphine, uroki-nase, low molecular weight heparin), while the observation group was treated with intravenous drip injection of ginseng injection in addition to the treatment in the control group. The heart function, ischemia modified protein (IMA), cre-atinekinase isoenzyme (CK-MB), brain natriuretic peptide (BNP), superoxide dismutase (SOD) activity and malondial-dehyde (MDA) levels were compared in patients between the two groups. Results There was no statistical signifi-cant differences in recanalization rate of reduction in ST segment elevation, chest pain, myocardial enzyme, and peak early recanalization (rate) between the two groups after thrombolysis treatment (P>0.05), but the incidence of arrhyth-mia in the observed group was significantly lower than in the control group (χ2=6.071, P=0.014<0.05). The IMA, CK-MB, BNP, SOD and MDA in the observation group were decreased or increased before and after treatment with statistical significance (P<0.05), while only the IMA CK-MB and BNP in the control group had statistically significant difference with those before the treatment (P<0.05). There were statistically significant differences in BNP, SOD, MDA level between the two groups after treatment (P<0.05). There were no significant differences in left ventricular end diastolic diameter, ejection fraction, the heart failure, shock and death between the two groups after treatment (P>0.05), but there was a statistically significant difference in the incidence of angina pectoris be-tween the two groups (χ2=11.77, P<0.05). Conclusion To combine with injection based on the conventional throm-bolysis treatment can reduce the complications, which can also improve the myocardial enzyme index and prognosis.