摘要
目的:探究阿替普酶联合依诺肝素钠治疗ST段抬高型心肌梗死(STEMI)的效果及其对心肌氧化应激反应的影响。方法:将本院2019年5月-2021年1月收治的116例STEMI患者随机分为A组(58例)、B组(58例),两组均在给予常规STEMI治疗(抗血小板、吸氧、抗心衰、抗凝等)的基础上使用阿替普酶静脉溶栓,A组加用普通肝素注射治疗,B组加用依诺肝素钠注射治疗。分析比较治疗后两组血管再通率差异,治疗前及治疗2 d后,比较两组患者心功能[左室舒张末期内径(LVEDd)、左室射血分数(LVEF)]、凝血功能[活化部分凝血活酶时间(APTT)、纤维蛋白原(Fib)]、氧化应激反应指标[总抗氧化能力(T-AOC)、丙二醛(MDA)]水平变化,观察治疗后两组药物不良反应发生情况差异。结果:治疗后,B组各时段血管再通率均明显高于A组;治疗2 d后,两组LVEDd、Fib、MDA水平均较治疗前有明显降低(P<0.05),LVEF、APTT、T-AOC水平均较治疗前有明显升高(P<0.05),且B组LVEDd、Fib、MDA水平明显低于同一时间A组(P<0.05),LVEF、APTT、T-AOC水平明显高于同时间A组(P<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。结论:阿替普酶联合依诺肝素钠治疗STEMI能有效提高患者血管再通率,保护心功能,减少氧化应激反应的发生,同时能改善患者预后效果,促进其康复,且药物安全性与A组用药方案相同。
Objective:To explore the efficacy of Alteplase combined with Enoxaparin Sodium in the treatment of ST-segment elevation myocardial infarction(STEMI)and its influence on myocardial oxidative stress response.Method:A total of 116 patients with STEMI admitted to our hospital from May 2019 and January 2021 were randomly divided into group A(58 cases)and group B(58 cases).Both groups were given intravenous thrombolysis of Alteplase on the basis of conventional STEMI therapy(anti-platelet,oxygen inhalation,anti-heart failure,anticoagulation,etc),and group A was treated with Unfractionated Heparin Injection and group B was treated with Enoxaparin Sodium Injection in addition.The difference in vascular recanalization rate was analyzed and compared between the two groups of patients after treatment.The cardiac function[left ventricular end diastolic diameter(LVEDd),left ventricular ejection fraction(LVEF)],coagulation function[activated partial thromboplastin time(APTT),fibrinogen(Fib)]and oxidative stress response indicators[total antioxidant capacity(T-AOC),malondialdehyde(MDA)]of the two groups were compared before treatment and after 2 days of treatment.The occurrence of adverse reactions of drug were observed in the two groups after treatment.Result:After treatment,the vascular recanalization rate during each time period in group B was significantly higher than that in group A.After 2 days of treatment,the levels of LVEDd,Fib and MDA of the two groups were significantly decreased(P<0.05),while the levels of LVEF,APTT and T-AOC were significantly increased compared with before treatment(P<0.05),the levels of LVEDd,Fib and MDA in group B were significantly lower than those in group A at the same time(P<0.05),while the levels of LVEF,APTT and T-AOC were significantly higher than those in group A at the same time(P<0.05).The adverse reaction of drug in two groups had no significant difference(P>0.05).Conclusion:Alteplase combined with Enoxaparin Sodium in the treatment of STEMI can effectively increase the vascular recan
作者
邓琴升
DENG Qinsheng(The First Affiliated Hospital of Xiamen University,Xiamen 361000,China)
出处
《中外医学研究》
2021年第29期53-57,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
ST段抬高型心肌梗死
阿替普酶
依诺肝素钠
治疗效果
心肌氧化应激反应
ST-segment elevation myocardial infarction
Alteplase
Enoxaparin Sodium
Treatment effect
Myocardial oxidative stress response
