磷酸肌酸钠对急性心肌梗死溶栓治疗再灌注损伤的防治作用  

Preventive and Therapeutic Effect of Creatine Phosphate Sodium in Treatment of Acute Myocardial Infarction Thrombolysis Reperfusion Injury

作　　者：陈宗跃[1] 焦丽强[1] 于明克[1] 

机构地区：[1]解放军251医院急救中心,河北张家口075000

出　　处：《解放军医药杂志》2012年第9期45-48,共4页Medical & Pharmaceutical Journal of Chinese People’s Liberation Army

摘　　要：目的探讨磷酸肌酸钠对急性心肌梗死(AMI)溶栓治疗再灌注损伤的防治作用。方法选择具有溶栓指征的AMI 116例,配对分为观察组与对照组(各58例)。两组均行常规治疗及尿激酶静脉溶栓治疗。观察组在使用尿激酶前10～30 min加用磷酸肌酸钠,先静脉推注3 g作为起始剂量,2 h后静脉滴注6 g(可溶于5%葡萄糖注射液30 ml中,糖尿病患者用生理盐水),控制在1 h内滴注完毕,第2～7日,视患者情况,每日静脉滴注6 g,速度同前,连用4 d。若患者情况危急或效果不理想,可以增加剂量至10 g。7 d为1个疗程。结果两组血压无明显变化(P>0.05),观察组治疗后心率、心肌耗氧量降低,血清肌酸激酶、肌酸激酶同工酶及肌钙蛋白T降低,心肌梗死面积缩小,左心室射血分数升高,与对照组相同时段比较差异均有统计学意义(P<0.05)。结论磷酸肌酸钠具有抗AMI再灌注损伤的作用。Objective To explore the preventive and therapeutic effect of creatine phosphate sodium in treatment of acute myocardial infarction （AMI） thrombolysis reperfusion injury. Methods 116 patients with thrombolysis indications of AMI, were divided into the treatment group （n = 58） and control group （n = 58 ） after matching. Both groups were treated with conventional therapy and urokinase intravenous thrombolysis therapy. The treatment group, 10 to 30 min before administration of urokinase, were given creatine phosphate sodium, with intravenous push of 3 g as the initial dose, two hours later intravenous drip of 6 g （soluble 5% glucose injection in 30 ml, patients with diabetes with physiological saline） finishing in 1 hour. On 2nd -7th day, depending on patients＇situations, intravenous drip of 6 g was given every day with the same speed for 4 days. If patients were in critical condition or the effect was unsatisfactory, the drip quantity could be increased to 10 g for 7 days （one course of treatment）. Results Blood pressures of both groups have no obvious change （ P 〉 0.05 ） ; in treatment group after treatment, heart rate, myocardial consumption of oxygen reduced, blood serum CK, CK-MB, CTnT and MI size decreased, and LVEF increased, which were all of statistical significance compared with those of control group （P 〈 0.05）. Conclusion Creatine phosphate sodium may stand against AMI reperfusion injury.

关 键 词：磷酸肌酸 心肌梗死 血栓溶解疗法 心肌再灌注损伤 

分 类 号：R977.4[医药卫生—药品] R541.4[医药卫生—药学]