托拉塞米注射液联合硝普钠注射液和尿激酶注射液治疗急性前壁心肌梗死患者的临床研究  

Clinical trial of torasemi injection combined with sodium nitroprusside injection and urokinase injection in the treatment of patients with acute anterior myocardial infarction

作　　者：刘帅 李洪芹 胡学军 卢玉梅 庞秀彬 胡亚丽 赵书红 张爱萍 田春梅 LIU Shuai;LI Hong-qin;HU Xue-jun;LU Yu-mei;PANG Xiu-bin;HU Ya-li;ZHAO Shu-hong;ZHANG Ai-ping;TIAN Chun-mei(Section 120 Emergency Center,Cancer Hospital,Cangzhou People’s Hospital,Cangzhou 061000,Hebei Province,China;Department of Cardiology,Cancer Hospital,Cangzhou People’s Hospital,Cangzhou 061000,Hebei Province,China;Department of Cardiology,Wuqiao County Integrated Traditional Chinese and Western Medicine Hospital,Wuqiao 061800,Hebei Province,China;Department of Cardiology,Cangzhou Bohai New District People’s Hospital,Cangzhou 061000,Hebei Province,China)

机构地区：[1]沧州市人民医院120急救中心,河北沧州061000 [2]沧州市人民医院肿瘤院区心内科,河北沧州061000 [3]吴桥县中西医结合医院内三科,河北吴桥061800 [4]沧州市渤海新区人民医院心内科,河北沧州061000

出　　处：《中国临床药理学杂志》2020年第15期2172-2174,2181,共4页The Chinese Journal of Clinical Pharmacology

基　　金：沧州市科技计划基金资助项目(151302023)。

摘　　要：目的观察托拉塞米注射液联合硝普钠注射液和尿激酶注射液治疗急性前壁心肌梗死患者的临床疗效及安全性。方法将158例急性前壁心肌梗死患者随机分为对照组和试验组,每组79例。2组患者均给予溶栓、抗凝等常规治疗。在此基础上,对照组给予3μg·kg^-1·min^-1硝普钠,qd,静脉泵入+尿激酶每次1.50×10^6 U,qd,30 min匀速静脉点滴;试验组在对照组治疗的基础上,给予托拉塞米每次20 mg,qd,静脉推注。2组患者均治疗14 d。比较2组患者的心肌梗死面积(MIA),血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)和肌钙蛋白Ⅰ(cTn-Ⅰ)水平,以及药物不良反应的发生情况。结果治疗后,试验组和对照组的MIA分别为(25.81±3.34)%和(29.44±4.19)%,CK分别为(194.24±66.87)和(232.80±59.34)U·L^-1,CK-MB分别为(23.33±6.04)和(27.16±7.31)U·L^-1,cTn-Ⅰ分别为(1.64±0.55)和(1.95±0.62)μg·L^-1,差异均有统计学意义(均P<0.05)。试验组发生的药物不良反应主要有眩晕、食欲缺乏、头痛和恶心,对照组发生的药物不良反应主要有眩晕、食欲缺乏和恶心。试验组和对照组的总药物不良反应发生率分别为7.59%和3.80%,差异无统计学意义(P>0.05)。结论托拉塞米注射液联合硝普钠注射液和尿激酶注射液治疗有利于降低急性前壁心肌梗死患者的心肌损伤、减小心肌梗死面积,且不增加药物不良反应的发生率。Objective To observe the clinical efficacy and safety of torasemi injection combined with sodium nitroprusside injection and urokinase injection in the treatment of patients with acute anterior myocardial infarction.Methods One hundred and fifty-eight patients with acute anterior myocardial infarction were randomly divided into control and treatment group with 79 cases per group.Control group was given 3μg·g^-1·min^-1 sodium nitroprusside,qd,intravenously pumped+urokinase 1.50×10^6 U,qd,30 min uniform intravenous drip.Treatment group received torasemi 20 mg,qd,intravenous injection,on the basis of control group.Two groups were treated for 14 days.The myocardial infarction area(MIA),serum levels of creatine kinase(CK),creatine kinase-myocardial band(CK-MB)and cardiac troponinⅠ(cTn-Ⅰ),and adverse drug reactions were compared between two groups.Results After treatment,the main indexes of treatment and control groups were compared:MIA were(25.81±3.34)% and(29.44±4.19)%,CK were(194.24±66.87)and(232.80±59.34)U·L^-1,CK-MB were(23.33±6.04)and(27.16±7.31)U·L^-1,cTn-Ⅰwere(1.64±0.55)and(1.95±0.62)μg·L^-1,the differences were statistically significant(all P<0.05).The adverse drug reactions of treatment group were vertigo,loss of appetite,headache and nausea,while those in the control group were vertigo,loss of appetite and nausea.The incidences of total adverse reactions in the treatment and control groups were 7.59% and 3.80% without significant difference(P>0.05).Conclusion Torasemi injection combined with sodium nitroprusside injection and urokinase injection can reduce myocardial injury and infarct size in patients with acute anterior wall myocardial infarction,without increasing the incidence of adverse drug reactions.

关 键 词：托拉塞米注射液 硝普钠注射液 尿激酶注射液 急性前壁心肌梗死 安全性评价 

分 类 号：R972[医药卫生—药品]