丹红注射液对急性心肌梗死溶栓后心肌再灌注损伤保护作用研究

王丽英，王国军，张彦玲，王志芹，田贵敏

(河北省赞皇县医院，河北 051230)

摘要：目的观察丹红注射液对急性心肌梗死(AMI)患者普佑克(注射用重组人尿激酶原)溶栓后心肌再灌注损伤的保护作用。方法选取我院2012年1月—2013年12月间收治的AMI经普佑克溶栓治疗后患者60例，随机分为观察组与对照组，2组患者均采用普佑克溶栓治疗。观察组溶栓治疗后即刻加用丹红注射液静滴治疗，对照组只采用溶栓后常规治疗。2组患者均以7 d为1疗程。对比2组患者心脏不良事件发生率及胸痛缓解情况,并测定2组患者血清N末端前脑钠肽(NT-Pro-BNP)、肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、及高敏C反应蛋白(hs-CRP)的水平变化情况。结果观察组患者溶栓3 h内心率失常、心绞痛、心力衰竭发生率显著低于对照组，组间比较差异有统计学意义(P<0.05);观察组患者治疗后血清cTnI、CK-MB峰值显著低于对照组，治疗1疗程后NT-Pro-BNP、Hs-CRP的水平均低于对照组，组间比较差异有统计学意义(P<0.05)。结论AMI患者经普佑克溶栓后加用丹红注射液，可降低患者心脏不良事件发生率，并有效地缓解胸痛症状、降低血清NT-Pro-BNP、Hs-CRP水平，对心肌具有保护作用。

关键词：急性心肌梗死；丹红注射液；普佑克；溶栓；心肌保护

DOI:10.13463/j.cnki.jlzyy.2015.02.013

中图分类号：R542.2文献标志码： A

文章编号：1003-5699(2015)02-0144-03

基金项目:河北省科技支撑项目(1414621153)。

作者简介:王丽英(1969-)，女，大学本科，副主任医师，主要从事内科疾病诊疗研究。

收稿日期:(责任编辑：王丹2014-11-18)

Protection of Danhong injection on myocardium reperfusion injury after AMI thrombolysis

WANG Liying,WANG Guojun,ZHANG Yanling,WANG Zhiqing,TIAN Guiming

(Zanhuang Hospital of Hebei Province,Zanhuang 051230,Hebei Province,China)

Abstract:ObjectiveTo observe the protective effect of Danhong injection on myocardium reperfusion injury in the acute myocardial infarction (AMI) patients after Puyouke (recombinant human prourokinase for injection) thrombolysis.MethodsA total of 60 AMI patients underwent Puyouke thrombolysis who were admitted in our hospital from January,2012 to December,2013 were included in our study and randomized into the observation group and the control group.The patients in the two groups were given Puyouke thrombolysis.After thrombolysis,Danhong injection was immediately added to the patients in the observation group;while the patients in the control group were only given conventional treatment after thrombolysis.Seven-day treatment was regarded as one course for both of the two groups.The occurrence rate of adverse cardiac events and how the chest pain was relieved in the two groups were compared.The levels of serum NT-Pro-BNP,cTnI,CK-MB,and hs-CRP in the two groups were determined.ResultsThe occurrence rates of arrhythmia,angina,and heart failure after thrombolysis within 3h in the observation group were significantly lower than those in the control group (P<0.05).The peak values of serum cTnI and CK-MB after treatment in the observation group were significantly lower than those in the control group,and the levels of NT-Pro-BNP and hs-CRP after one-course treatment were significantly lower than those in the control group (P<0.05).ConclusionAdding Danhong injection to the AMI patients after Puyouke thrombolysis can reduce the occurrence rate of adverse cardiac events,effectively alleviate chest pain,lower the serum NT-Pro-BNP and hs-CRP levels,and protect the myocardium.

Keywords:AMI；Dahong injection;Puyouke;thrombolysis;myocardial protection

急性心肌梗死(AMI)为临床急症，诱发原因众多，病情发展迅猛，病死率高[1]。经皮冠状动脉介入术(PCI)是最可靠的冠状动脉再灌注手段，疗效显著，已成为治疗AMI的首选方法[2]。但基层医院因受技术设备及人员操作水平的限制，多不具备开展PCI的条件，因此，静脉溶栓治疗，仍为基层医院的首选治疗方案。……