CAJ | 학술논문

目的比较分析发病6 h内急性前壁心肌梗死应用普通肝素(UFH)或低分子肝素(LWMH)抗凝辅助全量阿替普酶溶栓的临床疗效及安全性.方法96例急性心肌梗死患者按照随机数字表法分为UFH组与LWMH组各48例,2组患者在常规治疗基础上分别应用UFH或LWMH联合阿替普酶100 mg进行静脉溶栓,统计2组治疗后血管再通率、再灌注时间、心肌抢救指数、临床事件发生率、出血发生率.结果2组的临床再通率及平均再灌注时间比较差异无统计学意义,但2组最终心肌梗死面积及心肌抢救指数差异有显著统计学意义(P<0.05),总的主要心血管事件发生率差异有显著统计学意义(P<0.05),发病第3个月彩色多普勒超声左室舒张末内径(LVED)及左室射血分数(LVEF)差异有明显统计学意义(P<0.05).结论低分子肝素联合阿替普酶方案可以提高急性ST段抬高型前壁心肌梗死心肌抢救指数,显著降低临床心脏事件发生率和出血发生率,改善心功能.
목적비교분석발병6 h내급성전벽심기경사응용보통간소(UFH)혹저분자간소(LWMH)항응보조전량아체보매용전적림상료효급안전성.방법96례급성심기경사환자안조수궤수자표법분위UFH조여LWMH조각48례,2조환자재상규치료기출상분별응용UFH혹LWMH연합아체보매100 mg진행정맥용전,통계2조치료후혈관재통솔、재관주시간、심기창구지수、림상사건발생솔、출혈발생솔.결과2조적림상재통솔급평균재관주시간비교차이무통계학의의,단2조최종심기경사면적급심기창구지수차이유현저통계학의의(P<0.05),총적주요심혈관사건발생솔차이유현저통계학의의(P<0.05),발병제3개월채색다보륵초성좌실서장말내경(LVED)급좌실사혈분수(LVEF)차이유명현통계학의의(P<0.05).결론저분자간소연합아체보매방안가이제고급성ST단태고형전벽심기경사심기창구지수,현저강저림상심장사건발생솔화출혈발생솔,개선심공능.
Objective To compare the effect and safety of unfractionated heparin(UFH)or Low-molecular-weight heparin (LWMH)on anterior wall acute myocardial infarction combined with alteplase 6 hours after the onset. Methods 96 cases of acute myocardial infarction were devided rando-mly into UFH group and LMWH group,the two groups were treated with UFH or LMWH combined with ateplase 100mg respectively and the vascular recanalization rate,reperfusion time,the salvage index of myocardium、the rate of clinical event、the rate of hemorrhage were evaluated,the effect and complicaction of two groups were compared. Results There was no statistical significance between two groups in the vascular recanalization rate and reperfusion time. There was obviously statistical differences between two groups in the final myocardial infarction size、the salvage index of myocardium、the rate of hemorrhage、the rate of major adverse cardiovascular events(P<0.05),there was obviously statistical difference in LVED and LVEF by ultrasono-graphy in the first 3 months (P<0.05). Conclusion Low-molecular-weight heparin combined with alteplase can improve the salvage index of myocardium and lower clinical cardial events and the rate of hemorrhage of patients with anterior wall acute myocardial infarction with ST-segment elevation.