两种溶栓方法治疗急性冠脉综合征的结果分析  

Analysis of therapy for patients with acute coronary syndromes by two methods

作　　者：袁玉英[1] 杨志成 曾耀彬 

机构地区：[1]广东省惠州市第四人民医院内科,516055 [2]广东省惠州市惠阳区惠阳妇幼保健院内科,516200 [3]广东省惠州市惠城区马安医院,516000

出　　处：《中西医结合心血管病电子杂志》2014年第5期129-130,共2页Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的：探讨两种溶栓方法治疗急性冠脉综合征的临床价值。方法收集2012年3月-2014年3月 ST段抬高性急性心肌梗死（STEMI）病例100例，并随机为对照组（50例）和治疗组（50例）。对照组常规使用重组链激酶（rt-PA）、阿司匹林、低分子肝素、服用氯吡格雷75mg/d，连用3～5d；治疗组在对照组治疗的基础上，加用阿昔单抗0．25mg/kg弹丸注射，0．125mg/（kg·min）12h 持续滴注。观察两组疗效及溶栓前后血浆肌红蛋白（Myo）和肌酸激酶同工酶（CK-MB）含量及达峰值时间。结果治疗组总有效86．0％，明显高于对照组74．0％（x2＝11．5， P＜0．05）；两组溶栓后Myo、CK-MB含量均高于治疗前（P均＜0．01），治疗组溶栓后达峰值时间（5．0±1．9）h，明显低于对照组（12．3±1．1）h （t＝11．2，P＜0．05）。结论阿昔单抗联合治疗能提高临床疗效，血浆 Myo 和 CK-MB 含量测定可以用于AMI的早期诊断。Objective To explore the clinical value of thrombolytic therapy in two patients with acute coronary syndrome.Methods Collected in March,2012 -March 2012 sex st-elevation acute myocardial infarction （STEMI）cases,100 cases,and randomly as the control group （50 cases）and treatment group （50 cases）.The control group routine use of Recombinant tissue -plasminogen activator （rt-PA）,low molecular weight heparin,aspirin,clopidogrel 75 mg/days,connect to use 3~5 days;the treatment group based on the con-trol group treatment,plus abciximab bolus injection of 0.125mg/（0.25mg/kg,kg.min）12h continuous infusion.The thrombolytic efficacy、content of plasma myoglobin （Myo）、creatine kinase isoenzyme （CK-MB）and the time to reach the peak in two groups were observed before and after thrombolytic.Results Total effectiveness（86%）in the treatment group were significantly higher than that in control group（74%） （x2 =11.5,P〈0.05）;The contents of Myo and CK-MB after thrombolysis were higher than that before treatment （P〈0.01）,the time of peak in the treatment group after thrombolytic （5 ±1.9）h were significantly lower than the control group （12.3 ±1.1h （t =11.2, P〈0.05 ）.Conclusions：Abciximab therapy can improve the clinical efficacy,the levels of Myo and CK -MB can be used for early diagno-sis in patients with acute coronary syndrome.

关 键 词：急性冠脉综合征 重组链激酶 静脉溶栓 氯吡格雷 阿昔单抗 

分 类 号：R543.32[医药卫生—心血管疾病]