阿昔单抗联合低分子肝素治疗缺血后适应急性心肌梗死患者的预后分析  

Prognosis analysis of abciximab combined with low molecular heparin in treatment of ischemia postconditioning after acute myocardial infarction

作　　者：王道海[1] 

机构地区：[1]海口市人民医院急诊科,海南海口570208

出　　处：《中国急救医学》2015年第3期248-250,共3页Chinese Journal of Critical Care Medicine

摘　　要：目的：分析阿昔单抗联合低分子肝素治疗缺血后适应急性心肌梗死（ AMI）的临床疗效及安全性。方法选取我院2011－04-2014－04收治的缺血后适应AMI患者772例，按照其治疗方式分为观察组（n＝428）及对照组（n＝344）。观察组接受阿昔单抗联合低分子肝素治疗，对照组仅接受低分子肝素治疗，比较两组患者12 h的血管再通率，以及治疗3个月后血清肌酸激酶（ CK）、肌酸激酶同工酶（ CK－MB）、左心室舒张期末容积指数（ LVEDVI）、左心室收缩期末容积指数（ LVESVI）、左室射血分数（ LVEF）和3个月内心脏事件发生率。结果两组患者治疗后CK、CK－MB、LVEDVI及LVESVI与治疗前比较均显著降低，LVEF明显升高（P＜0．05）；观察组改善程度较对照组更为明显（P＜0．05）；观察组12 h血管再通296例，再通率69．2％；对照组12 h血管再通95例，再通率27．6％；观察组血管再通率明显高于对照组（P＜0．05）。观察组心脏事件发生145例，发生率33．9％；对照组发生254例，发生率73．8％；观察组心脏事件发生率明显低于对照组（ P＜0．05）。结论阿昔单抗联合低分子肝素能够有效改善患者心脏功能，降低心脏事件发生率，对其预后及生存质量的改善具有积极的意义，值得进一步研究。Objective To analyze the abciximab combined with low molecular weight heparin in the treatment of ischemic postconditioning after acute myocardial infarction （ AMI） the clinical efficacy and safety.Methods A total of 772 ischemic postconditioning AMI patients from April 2011 to April 2014 were included in this study.The patients were divided into observation group （ n =428 ） and control group （ n=344 ）： the observation group received abciximab plus low molecular weight heparin therapy, the control group only received low molecular weight heparin therapy;comparison of 12 hours the re-passing the rate of blood vessels between two groups of patients, and the serum creatine kinase （CK）, creatine kinase isoenzyme（CK-MB）, left ventricular end diastolic volume index（LVEDVI）, left ventricular end systolic volume index（LVESVI）and left ventricular ejection fraction（LVEF）index 3 months after treatment and cardiac events within 3 months.Results The level of CK, CK -MB, LVEDVI, LVESVI were significantly decreased in the two groups after treatment, and the level of LVEF was singificantly increased （ P 〈0.05）, the observation group improvement was more obvious than control group （ P 〈0.05 ） .296 cases in observation group were of vascular recanalization, with a recanalization rate of 69.2%, but only 95 cases in control group 95 cases were of recanalization, with a recanalization rat of 27.6%, the recanalization rate was significantly higher than that in control group. 145 patients in the observation group and 254 cases in control group occurred cardiac events, with a cardiac events incidence of 33.9% and 73.8%, respectively; the incidence of cardiac events was significantly lower in the observation group than that in the control group.Conclusion Abciximab＆nbsp;combined with low molecular weight heparin can effectively improve cardiac function, reduce the incidence of cardiac events.It is of positive significance to the prognosis and the improvement of the quality of life, worthy o

关 键 词：阿昔单抗 低分子肝素 缺血后适应 急性心肌梗死( AMI) 

分 类 号：R473.5[医药卫生—护理学]