摘要
目的:观察院前抗凝治疗对ST段抬高心肌梗死患者预后的影响。方法:选取我院我院自2014年3月至2016年2月急诊收治的ST段抬高的急性心肌梗死患者56例,随机分为观察组(院前抗凝治疗)与对照组(常规处置),每组各28例,评价两组患者院前及入院后抢救结果,对比治疗后血浆人组织纤溶酶原激活物(t-PA)、人纤溶酶原激活剂抑制物(PAI-1)表达水平,记录近期心血管事件及不良反应发生情况。结果:观察组院前抢救有效率为96.43%,对照组院前抢救有效率为92.86%(χ~2=0.35,P=0.55);观察组入院后抢救有效率为92.86%,对照组患者入院后抢救有效率为92.86%(χ~2=0,P=1.00)。病情平稳后,观察组患者t-PA表达水平高于对照组(t=3.53,P=0.00095),PAI-1表达水平低于对照组(t=2.51,P=0.016)。两组患者胃肠道不适(χ~2=0.09,P=0.76)、瘀斑(χ~2=0.12,P=0.73)及消化道出血(χ~2=0.18,P=0.67)发病率差异具有统计学意义。观察组患者近期心血管事件发生率为12.00%,低于对照组的41.67%(χ2=5.53,P=0.019)。结论:院前抗血小板治疗能够降低ST段抬高心肌梗死患者近期心血管事件发生率,改善患者纤溶失衡状态,同时不增加患者不良反应,值得临床推广应用。
Objective：To observe the effect of pre-hospital antiplatelet therapy on the prognosis of patients with myocardial infarction with ST-segment elevation.Methords： 56 patients with ST-segment elevation acute myocardial infarction admitted to our hospital from March 2014 to February 2016 were randomly divided into observation group （pretreated anticoagulant therapy） and control group （routine treatment）, with 28 patients in each group.The results of prehospital and post-hospital resuscitation were evaluated.the levels of plasminogen activator （t-PA）, plasminogen activator inhibitor-1 （PAI-1）, and record the occurrence of cardiovascular events and adverse reactions were compared.Results： The effective rate of pre-hospital rescue was 96.43% in the observation group and 92.86% in the control group, the difference was not statistically significant （x2=0.35, p=0.55）;the effective rate of the observation group was 92.86%, and the effective rate was 92.86% in the control group.The difference was not statistically significant （x2=0, p=1.00）.The level of t-PA expression in observation group was higher than that in control group （t=3.53, p=0.00095）, and the level of PAI-1 was lower than that of control group （t=2.51, p=0.016）.The incidence of gastrointestinal discomfort （x2=0.09, p=0.76）, ecchymosis （x2=0.12, p=0.73） and gastrointestinal bleeding （x2=0.18, p=0.67） were not statistically different between the two groups.The incidence of cardiovascular events in the observation group was 12.00%, which was significantly lower than that in the control group （41.67%）.The difference was statistically significant （x2=5.53, p=0.019）.Conclusion： Pre-hospital anti-platelet therapy can reduce the incidence of cardiovascular events in patients with ST-segment elevation myocardial infarction and improve the patients＇fibrinolysis imbalance without increasing the side effects.It is worthy of clinical application.
出处
《河北医学》
CAS
2017年第4期616-620,共5页
Hebei Medicine
基金
彝族地区县(市)级综合医院应急救治突发公共卫生事件模式研究
(编号:15YYJS035)
关键词
院前
抗凝
ST段抬高心肌梗死
纤溶系统
预后
Prehospital
Anticoagulation
ST-segment elevation myocardial infarction
Fibrinolytic system
Prognosis
