摘要
目的:探讨血栓抽吸联合阿替普酶在心肌梗死患者中的临床疗效及对微循环的影响。方法:选择将乐县总医院2017年4月—2018年11月收治的168例心肌梗死患者,随机分为对照组和观察组,各84例。对照组给予阿替普酶治疗,观察组在对照组基础上联合血栓抽吸治疗,治疗后1周对患者效果进行评估,比较两组心肌损伤、心功能水平、微循环等恶性事件发生情况,随访6个月比较两组的死亡率。结果:治疗后1周,观察组的肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)及N末端脑钠肽前体(NT-proBNP)水平低于对照组(P<0.05)。治疗后1周,观察组声学峰值强度(PI)、曲线下面积(AUC)均高于对照组,ST段低于对照组(P<0.05)。治疗后1周,观察组QT离散度(QTd)短于对照组(P<0.05)。治疗后6个月,两组死亡率比较,差异无统计学意义(P>0.05);治疗后1个月及3个月,观察组的死亡率均低于对照组(P<0.05)。观察组心律失常、心源性休克及出血发生率均低于对照组(P<0.05)。结论:血栓抽吸联合阿替普酶用于心肌梗死患者能减轻心肌损伤,改善患者微循环,降低恶性事件及死亡发生率,值得推广应用。
Objective:To investigate the clinical efficacy of thrombus aspiration combined with Alteplase in patients with myocardial infarction and its effect on microcirculation.Method:A total of 168 patients with myocardial infarction admitted to Jiangle County General Hospital from April 2017 to November 2018 were selected as subjects and randomly divided into control group and observation group,with 84 cases in each group.The control group was treated with Alteplase,and the observation group was treated with thrombus aspiration on the basis of the control group.The effect of the treatment was evaluated 1 week after treatment.The incidence of myocardial injury,cardiac function,microcirculation and other malignant events were compared between the two groups,and the mortality of the two groups was compared after 6 months of follow-up.Result:One week after treatment,the levels of creatine kinase isoenzyme(CK-MB),cardiac troponin I(cTnI)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in the observation group were lower than those in the control group(P<0.05).One week after treatment,the acoustic peak intensity(PI)and area under the curve(AUC)in the observation group were higher than those in the control group,ST segment was lower than that in the control group(P<0.05).One week after treatment,the QT dispersion(QTd)in the observation group was shorter than that in the control group(P<0.05).Six months after treatment,there was no significant difference in mortality between the two groups(P>0.05).One month and three months after treatment,the mortality of the observation group was lower than that of the control group(P<0.05).The incidence of arrhythmia,cardiogenic shock and bleeding in the observation group were lower than those in the control group(P<0.05).Conclusion:Thrombus aspiration combined with Alteplase in patients with myocardial infarction can reduce myocardial damage,improve microcirculation,reduce malignant events and mortality,and it is worthy of popularization and application.
作者
肖春林
陈美秀
XIAO Chunlin;CHEN Meixiu(Jiangle County General Hospital,Jiangle 353300,China;不详)
出处
《中外医学研究》
2023年第3期45-49,共5页
CHINESE AND FOREIGN MEDICAL RESEARCH
关键词
血栓抽吸
阿替普酶
心肌梗死
心肌损伤
心功能
微循环
恶性事件
Thrombus aspiration
Alteplase
Myocardial infarction
Myocardial injury
Cardiac function
Microcirculation
Malignant events
