本文選題：急性心肌梗死　切入點(diǎn)：靜脈溶栓　出處：《廣東醫(yī)學(xué)》2017年S1期

【摘要】：目的觀察阿替普酶對(duì)急性心肌梗死患者心肌損傷標(biāo)志物及心功能的影響。方法選擇急性ST段抬高型心肌梗死患者92例為研究對(duì)象,根據(jù)入院時(shí)間先后順序隨機(jī)分為觀察組和對(duì)照組各46例,對(duì)照組給予尿激酶靜脈溶栓治療,觀察組使用阿替普酶治療,比較兩組心肌損傷標(biāo)志物、心功能、再通率及心血管事件發(fā)生率。結(jié)果觀察組血清N末端腦鈉肽前體、肌酸激酶同工酶、心肌鈣蛋白含量均明顯低于對(duì)照組(t=11.408、14.933、10.816,P0.05);左室射血分?jǐn)?shù)明顯高于對(duì)照組,左心室舒張末直徑明顯低于對(duì)照組(t=5.690、3.421,P0.05);兩組患者冠脈再通率、出血率、低血壓、惡性心律失常、心源性死亡發(fā)生率均差異無(wú)統(tǒng)計(jì)學(xué)意義(X~2=0.080、0.155、0.713、2.190,P0.05)。結(jié)論阿替普酶靜脈溶栓治療有助于降低急性心肌梗死患者血清心肌損傷標(biāo)志物表達(dá)水平,改善心功能,且安全有效。
[Abstract]:Objective to observe the effects of atropase on myocardial injury markers and cardiac function in patients with acute myocardial infarction. Methods 92 patients with acute St segment elevation myocardial infarction were selected as subjects. According to the order of admission time, the patients were randomly divided into the observation group (n = 46) and the control group (n = 46). The patients in the control group were treated with urokinase intravenous thrombolytic therapy, and the patients in the observation group were treated with atropine enzyme. Results the contents of serum N-terminal brain natriuretic peptide precursor, creatine kinase isoenzyme and cardiac troponin in the observation group were significantly lower than those in the control group, and the left ventricular ejection fraction was significantly higher than that in the control group. The left ventricular end-diastolic diameter was significantly lower than that of the control group (5.690 ~ 3.421) (P 0.05), and the coronary artery recanalization rate, bleeding rate, hypotension, malignant arrhythmia in both groups were significantly lower than those in the control group. There was no significant difference in the incidence of cardiac death. Conclusion intravenous thrombolytic therapy with atropine can reduce the expression level of serum myocardial injury markers and improve cardiac function in patients with acute myocardial infarction, and it is safe and effective.
【作者單位】： 北京大學(xué)國(guó)際醫(yī)院急診科;
【分類號(hào)】：R542.22

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