蝮蛇抗栓酶治疗急性心肌梗死及心肌缺血的疗效  

Curative Effect of Ahylysantinfarctase on Acute Myocardial Infarction and Myocardial Ischemia

作　　者：杨岳珍 

机构地区：[1]黄石市第一医院内科,湖北黄石4350001

出　　处：《实用临床医学（江西）》2011年第8期22-23,30,共3页Practical Clinical Medicine

摘　　要：目的探求蝮蛇抗栓酶(AFT)治疗急性肌梗死及心肌缺血的疗效与机理。方法将29例急性心肌梗死患者和163例心肌缺血患者按治疗方法不同分为2组:治疗组109例(急性心肌梗死17例、心肌缺血92例)给予AFT(0.25～0.5U加入5%葡萄糖溶液250mL中,静脉点滴,29～30滴.min-1,1次.d-1,15～20d为1个疗程)治疗;对照组83例(急性心肌梗死12例、心肌缺血71例)给予低分子右旋糖苷加丹参(低分子右旋糖苷250mL加丹参10mL静脉滴注)治疗。结果治疗组治疗急性心肌梗死显效9例,改善6例,死亡2例,总有效率88.2%;治疗心肌缺血显效73例,改善14例,无效5例,总有效率94.5%。对照组治疗急性心肌梗死显效2例,改善2例,死亡和无效共8例,总有效率33.4%;治疗心肌缺血显效7例,改善20例,无效44例,总有效率38.1%。2组总有效率相比,差异有统计学意义(P<0.01),AFT治疗心肌梗死和心肌缺血的效果明显优于低分子右旋糖苷加丹参组。结论 AFT是具备良好抗凝功效的制剂,防止急性心肌梗死溶栓后血液的高凝状态,激活纤溶系统,避免再梗死的发生;AFT可使引起血管痉挛收缩的血管活性物质ET减少,使内皮依赖性血管舒张因子(EDRF)NO的含量升高,故可缓解血管痉挛,舒张血管,恢复心肌供血,防止溶栓后血管痉挛及血液高凝状态引起的再梗死可能。Objective To explore the curative effect of ahylysantinfarctase（AFT） on acute myocardial infarction（AMI） and myocardial ischemia（MI）,and to investigate the mechanism of AFT action.Methods Twenty-nine patients with AMI and 163 patients with MI were divided into two groups.Patients in treatment group（17 patients with AMI and 92 patients with MI） were intravenously infused with 0.25 to 0.5 U of AFT in 250 mL of 5% dextrose solution at a rate of 29 to 30 drops per minute once per day for 15 to 20 days.Patients in Control group（12 patients with AMI and 71 patients with AI） were intravenously infused with 250 mL of low molecular dextran and 10 mL of salvia miltiorrhiza.Results Among the 17 patients with AMI treated with AFT,9 had excellent results,6 achieved improvement and 2 died,with a total effective rate of 88.2%.Among the 92 patients with MI treated with AFT,73 had excellent results,14 achieved improvement and 5 received ineffective therapy,with a total effective rate of 94.5%;Among the 12 patients with AMI treated with low molecular dextran and salvia miltiorrhiza,2 had excellent results,2 achieved improvement and 8 died or received ineffective therapy,with a total effective rate of 33.4%.Among the 71 patients with MI treated with low molecular dextran and salvia miltiorrhiza,7 had excellent results,20 achieved improvement and 44 received ineffective therapy,with a total effective rate of 38.1%.There were obvious differences in excellent effective rate and total effective rate between the two groups（P〈0.01）.Conclusion AFT is a good antithrombotic agent,which can prevent hypercoagulability after thrombolytic therapy of AMI,activate fibrinolytic system,and prevent the occurrence of reinfarction.Furthermore,AFT may reduce the release of vasoactive substance ET and increase the concentration endothelium-derived relaxing factor NO.Therefore,AFT can relieve vasospasm,relax blood vessel,restore blood flow to myocardium,and prevent reinfarction induced by vasospasm and hypercoagulability after t

关 键 词：蝮蛇抗栓酶 心肌梗死 心肌缺血 

分 类 号：R541.78[医药卫生—心血管疾病]