不同治疗方案在急性心肌梗死患者中的应用研究

虞君

[摘要]目的探讨不同治疗方案在急性心肌梗死患者中的治疗效果。方法回顾性选取2015年8月至2020年8月于山东省聊城市中医医院治疗的急性心肌梗死患者65例作为研究对象。依据治疗方法不同进行分组，采用静脉溶栓及常规西医治疗的患者32例作为对照组，在对照组治疗基础上加用活血化瘀中药注射剂治疗的33例患者作为研究组。比较治疗前后两组心功能以及主要心脏不良事件的发生情况。结果治疗前后，各组内左心室射血分数（LVEF）、N 末端 B 型利尿钠肽原（NT-proBNP）及6 min 步行试验（6MWT）比较，差异有统计学意义（P <0.05）;治疗前，组间 LVEF， NT-proBNP及6MWT 差异无统计学意义（ P >0.05），治疗后，研究组各项指标均優于对照组，差异有统计学意义（ P <0.05）。研究组主要心脏不良事件总发生率为6.06%，低于对照组的25.00%，组间差异有统计学意义（ P <0.05）。结论针对急性心肌梗死患者实施静脉溶栓加用活血化瘀中药注射剂治疗，两者之间相互结合，能够恢复心肌血流，促进心功能的恢复，且可明显降低患者治疗后的主要心脏不良事件发生。

[关键词]急性心肌梗死;静脉溶栓;活血化瘀中药注射剂;灯盏花素注射液;心功能

[中图分类号] R542.22  [文献标识码] A   [文章编号]2095-0616（2021）24-0097-04

Application of different treatment schemes in patients with acute myocardial infarction

YU  Jun

Department of Cardiology， Liaocheng Hospital of traditional Chinese Medicine， Shandong， Liaocheng 252000， China

[Abstract] Objective To explore the therapeutic effect of different treatment schemes in patients with acute myocardial infarction. Methods A total of 65 patients with acute myocardial infarction treated in Liaocheng Hospital of traditional Chinese Medicine from August 2015 to August 2020 were retrospectively selected as the research objects. According to the different treatment methods， 32 patients treated with intravenous thrombolysis and conventional western medicine were used as the control group， and on the basis of the control group， 33 patients treated with traditional Chinese medicine injection for promoting blood circulation and removing blood stasis were used as the study group. The cardiac function and the occurrence of major cardiac adverse events of the two groups before and after treatment were compared. Results The differences of left ventricular ejection fraction（LVEF）， N terminal pro B type natriuretic peptide （NT-proBNP） and 6-minute walk test （6MWT） in each group before and after treatment were statistically significant （P <0.05）; Before treatment， there was no significant difference in LVEF， NT proBNP and 6MWT between groups （P >0.05）， after treatment， the indexes in the study group were better than those in the control group， the difference was statistically significant （P <0.05）. The total incidence of the occurrence of major cardiac adverse events in the study group was 6.06%， which was lower than 25.00% in the control group （P <0.05）. Conclusion Intravenous thrombolytic therapy combined with traditional Chinese medicine injection for promoting blood circulation and removing blood stasis for patients with acute myocardial infarction can restore myocardial blood flow， promote the recovery of cardiac function， which can significantly reduce the occurrence of major cardiac adverse events after treatment.

[Key words] Acute myocardial infarction; Intravenous thrombolysis; Traditional Chinese medicine injection; Breviscapine injection; Cardiac function

急性心肌梗死是指冠状动脉发生急性闭塞，血流中断，从而导致严重并且持久的心肌缺血性坏死，其常伴发心律失常、休克或者心力衰竭等，其临床特点主要表现为突发性、剧烈并且持久的胸骨后疼痛，致死率较高，常可危及患者生命[1]。因此，针对急性心肌梗死患者，为使患者的心肌在短时间内恢复血液灌注，进行梗死相关血管的开通尤为重要，且可降低相关并发症的发生及改善远期预后等。目前临床上静脉溶栓方法是较为有效的手段，但静脉溶栓的治疗效果与开始溶栓的时间紧密相关，在患者发生急性心肌梗死后的1 h 为静脉溶栓的最佳治疗时间[2]。开始溶栓时间越早，血管再通发生率越高，则致死率越低，预后越好。……