CAJ | 학술논문

目的观察联合应用拜阿司匹林、血栓通粉针剂对治疗心肺复苏(CPR)成功患者的疗效及安全性.方法采用前瞻性临床随机对照研究方法,将 CPR 成功的患者按入院顺序分为研究组和对照组.研究组患者在 CPR 成功后常规口服拜阿司匹林100 mg、每日1次,静脉滴注血栓通0.3 g、12 h 1次,治疗15 d ;对照组患者给予常规治疗.于 CPR 后1、5、15、30 d 取静脉血,采用快速荧光免疫法检测 N 末端脑钠肽前体(NT-proBNP),并行心脏彩色超声观察心功能指标;于治疗12、24、48、72、96 h 测定肌酸激酶同工酶(CK-MB).结果以复苏成功为始点,观察30 d 后为终点.研究组有8例因再次心功能衰竭死亡,对照组有13例因再次心功能衰竭死亡,研究组复苏后病死率明显低于对照组〔25.8%(8/31)比35.1%(13/37),P<0.01〕.最终研究组入选23例,对照组入选24例.两组随治疗时间延长,左室心功能指标每搏量(SV)、左室射血分数(LVEF)、左室收缩期末内径(LVESD)、左室舒张期末内径(LVEDD)均明显好转,且研究组优于对照组〔30 d SV(ml):65.4±8.4比61.1±9.0,LVEF:0.558±0.056比0.461±0.071,LVESD(mm):45.7±5.2比41.3±5.8,LVEDD(mm):99.7±9.1比91.1±8.9,均P<0.05〕.研究组静脉血 NT-proBNP、CK-MB 的恢复也明显优于对照组(P<0.05或P<0.01).结论联合应用拜阿司匹林、血栓通能显著降低 CPR 成功后患者的病死率,提高 CPR 成功后患者的生存率及生存质量.
목적관찰연합응용배아사필림、혈전통분침제대치료심폐복소(CPR)성공환자적료효급안전성.방법채용전첨성림상수궤대조연구방법,장 CPR 성공적환자안입원순서분위연구조화대조조.연구조환자재 CPR 성공후상규구복배아사필림100 mg、매일1차,정맥적주혈전통0.3 g、12 h 1차,치료15 d ;대조조환자급여상규치료.우 CPR 후1、5、15、30 d 취정맥혈,채용쾌속형광면역법검측 N 말단뇌납태전체(NT-proBNP),병행심장채색초성관찰심공능지표;우치료12、24、48、72、96 h 측정기산격매동공매(CK-MB).결과이복소성공위시점,관찰30 d 후위종점.연구조유8례인재차심공능쇠갈사망,대조조유13례인재차심공능쇠갈사망,연구조복소후병사솔명현저우대조조〔25.8%(8/31)비35.1%(13/37),P<0.01〕.최종연구조입선23례,대조조입선24례.량조수치료시간연장,좌실심공능지표매박량(SV)、좌실사혈분수(LVEF)、좌실수축기말내경(LVESD)、좌실서장기말내경(LVEDD)균명현호전,차연구조우우대조조〔30 d SV(ml):65.4±8.4비61.1±9.0,LVEF:0.558±0.056비0.461±0.071,LVESD(mm):45.7±5.2비41.3±5.8,LVEDD(mm):99.7±9.1비91.1±8.9,균P<0.05〕.연구조정맥혈 NT-proBNP、CK-MB 적회복야명현우우대조조(P<0.05혹P<0.01).결론연합응용배아사필림、혈전통능현저강저 CPR 성공후환자적병사솔,제고 CPR 성공후환자적생존솔급생존질량.
Objective To observe the safety and curative effect of combined therapy of aspirin(Bayer) tablet and Xueshuantong injection on patients with successful cardiopulmonary resuscitation(CPR). Methods A prospective randomized clinical contrast method was conducted. Successful CPR patients were divided into a research group and a control group by admission time sequence. The research group patients were given routine therapy and orally took aspirin(Bayer)tablet,100 mg once a day,and were injected Xueshuantong injection,0.3 g,once every 12 hours,while the control group patients were only given routine therapy,the therapeutic course being 15 days in both groups. On 1,5,15,30 days after CPR,venous blood was collected to quantitatively measure N-terminal pro-brain natriuretic peptide(NT-proBNP)by rapid fluorescence immunoassay method,and in the mean time,all patients accepted heart color Doppler ultrasound examination to observe the changes of heart function. At the 12th,24th,48th, 72th,96th hour after CPR,the activity of creatine kinase isoenzyme MB(CK-MB)in blood was tested by immune suppression method. Results The research of observation began from the success of CPR,and its end was 30 days away from the day of CPR success. Only did 8 cases in the research group died of heart failure again in the 30 days, while in the control group,this number was 13 cases,the death rate of the research group being obviously lower than that in the control group〔25.8%(8/31)vs. 35.1%(13/37),P<0.01〕. Finally 23 cases were enrolled in research group,and 24 cases in control group. With prolongation of therapy,the stroke volume(SV),left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD) of the patients in the two groups improved significantly,and the improvement was better in the research group than that in the control group〔30 days SV(ml):65.4±8.4 vs. 61.1±9.0,LVEF:0.558±0.056 vs. 0.461±0.071,LVESD (mm):45.7±5.2 vs. 41.3±5.8,LVEDD(mm):99.7±9.1 vs. 91.1±8.9,all P<0.05〕. The improvement of venous blood NT-proBNP and CK-MB in the research group was also much better than that in the control group(P<0.05 or P<0.01). Conclusion The combined therapy of aspirin(Bayer)tablet and Xueshuantong injection not only can remarkably decrease the death rate of patients who have obtained successful CPR,but also improve survival rate and quality of life.