發(fā)布時(shí)間：2018-03-26 19:27

  本文選題：冠心病　切入點(diǎn)：急性心肌梗死　出處：《重慶醫(yī)科大學(xué)學(xué)報(bào)》2016年09期

【摘要】：目的:探討遠(yuǎn)隔器官后適應(yīng)聯(lián)合應(yīng)用依達(dá)拉奉對(duì)急性心肌梗死患者心肌缺血再灌注損傷的作用。方法:選取2013年01月至2014年12月我院收治的急性心肌梗死患者144例,隨機(jī)分為I/R組(靜脈溶栓治療)、RPOC組(靜脈溶栓治療+遠(yuǎn)隔器官后適應(yīng)治療)、E組(靜脈溶栓+依達(dá)拉奉注射液靜脈點(diǎn)滴)、ER組(靜脈溶栓+遠(yuǎn)隔器官后適應(yīng)+依達(dá)拉奉注射液靜脈點(diǎn)滴),每組36例,分析各組患者肌酸激酶同工酶(creatine kinase isoenzymes,CKm B)及肌鈣蛋白(cardiac troponinⅠ,c Tn I)分泌峰值及其動(dòng)態(tài)變化,同時(shí)比較各組患者溶栓治療后超聲心動(dòng)圖指標(biāo),治療后進(jìn)行隨訪,觀察不良事件發(fā)生情況。結(jié)果:CKm B、c Tn I峰值在I/R組、E組、RPOC組、ER組患者中依次降低,組間差異均具有統(tǒng)計(jì)學(xué)意義(P0.05);與I/R組比較,E組、EROC組、ER組患者左室舒張末內(nèi)徑(left ventricular enddiastolic,LVED)、計(jì)算室壁節(jié)段運(yùn)動(dòng)指數(shù)(wall motion score index,WMSI)均明顯降低,左室射血分?jǐn)?shù)(left ventricular ejection fractions,LVEF)%明顯升高(P0.05);ER組患者LVED、WMSI均明顯低于E組和RPOC組(P0.05),LVEF%明顯高于E組和RPOC組(P0.05),WMSI明顯低于E組(P0.05),但與RPOC組比較差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05);4組患者治療后均隨訪3個(gè)月,隨訪期間均無(wú)失訪和死亡病例,E組、EROC組、ER組再梗死、腦卒中、梗死后心絞痛、心力衰竭等不良事件發(fā)生率均明顯低于I/R組(P0.05),但3組間比較,差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:遠(yuǎn)隔器官后適應(yīng)及依達(dá)拉奉的應(yīng)用都能顯著減少CKm B和c Tn I的釋放,減輕急性心肌梗死后心室重塑,改善室壁運(yùn)動(dòng),從而減輕心肌再灌注的損傷,改善預(yù)后。
[Abstract]:Objective: to investigate the effect of combined use of Edaravone on myocardial ischemia-reperfusion injury in patients with acute myocardial infarction. Methods: 144 patients with acute myocardial infarction admitted to our hospital from January 2013 to December 2014 were selected. I / R group (intravenous thrombolytic therapy) RPOC group (intravenous thrombolytic therapy for distal organ adaptation therapy) E group (intravenous thrombolytic Edaravone injection intravenous drip of ER group (intravenous thrombolytic distal organ adaptation Edara group). 36 patients in each group were treated by intravenous drip. The peak and dynamic changes of creatine kinase isoenzymers CKm B (creatine kinase isoenzymers CKm B) and cardiac cardiac troponin 鈪，

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