摘要
目的观察法舒地尔对急性心肌梗死患者心电图ST段回落的影响及心肌缺血再灌注损伤的保护作用,为急性心肌梗死患者的临床治疗提供参考。方法选择2013年6月—2017年7月空军军医大学唐都医院急诊科收治的急性心肌梗死患者80例作为研究对象,随机数字表法分为2组,各40例。对照组给予钙离子拮抗剂、阿司匹林、β受体阻滞剂等常规治疗,观察组在对照组的基础上另加法舒地尔联合治疗,均治疗3周,分析2组患者心电图ST段回落情况及心功能变化情况,比较2组患者治疗前后血清肌酸磷酸激酶同工酶(CK-MB)、肌钙蛋白I(cTnI)等心肌损伤指标变化以及血清丙二醛(SOD)、超氧化物歧化酶(MDA)氧化应激指标水平变化。结果观察组治疗后心电图ST段回落率明显高于对照组(92. 50%vs. 75. 00%,χ~2/P=5. 541/0. 019)。2组患者治疗前△T、LVEF、LVESD、LVEDD等心功能指标以及c Tn I、CK-MB、MDA、SOD等心肌损伤指标比较,差异无统计学意义(P> 0. 05)。与治疗前相比,2组上述指标均改善,而观察组改善较对照组更为显著(t/P=3. 861/0. 000、7. 016/0. 000、4. 264/0. 000、7. 000/0. 000、21. 079/0. 000、14. 260/0. 000、23. 852/0. 000、14. 047/0. 000)。结论法舒地尔可以明显降低急性心肌梗死患者心肌缺血再灌注损伤,显著提高心电图ST段回落率,改善心功能,值得临床深入研究。
Objective To investigate the effect of Fasudil on the decline of ECG ST segment and the protective effect of myocardial ischemia reperfusion injury in patients with acute myocardial infarction,and to provide reference for the clinical treatment of patients with acute myocardial infarction.Methods Eighty patients with acute myocardial infarction admitted to our hospital from June 2013 to July 2017 were selected as study subjects and randomly divided into observation group and control group,40 cases in each group.The control group was given routine treatment,observation group in addition to fasudil combination therapy on the basis of the control group,analysis of two groups of patients ECG ST segment depression.The changes of myocardial injury indexes such as serum malondialdehyde(MDA),serum creatine phosphokinase(CK-MB)and troponin I(cTnI)were compared between the two groups before and after treatment,and analyze the changes in left ventricular function.Results Before treatment,the△T,LVEF,LVESD and LVEDD cardiac function indexes and the indexes of myocardial injury such as cTnI,CK-MB,MDA and SOD in the two groups did not show significantly different(t/P=0.271/0.394,0.437/0.332,0.102/0.460,0.184/0.427,0.494/0.311,0.516/0.304,0.715/0.238,0.516/0.304).Compared with the pre-treatment,the two groups of patients have improved the above indicators,while the observation group improved more significantly,the difference was statistically significant(t/P=3.861/0.000,7.016/0.00,4.264/0.00,7.000/0.00,21.079/0.00,14.260/0.00,23.852/0.00,14.047/0.00),the observation group patients’after treatment ECG ST segment resolution was significantly higher than the control group(χ2/P=5.541/0.019).Conclusion Fasudil can significantly reduce the myocardial ischemia reperfusion injury in patients with acute myocardial infarction,significantly improve the ECG ST segment resolution and improve cardiac function,deserving clinical in depth study.
作者
王琦
校建波
李海荣
李佩阳
曾迪
王伯良
WANG Qi;XIAO Jianbo;LI Hairong;LI Peiyang;ZENG Di;WANG Boliang(Department of Emergency,Tangdu Hospital,Air Force Medical University,Shaanxi,Xi'an 710038,China)
出处
《疑难病杂志》
CAS
2018年第11期1192-1195,1204,共5页
Chinese Journal of Difficult and Complicated Cases
基金
国家自然科学基金青年项目(31400832)
关键词
法舒地尔
心肌梗死
急性
心电图ST段回落
缺血再灌注
心肌保护
Fasudil
Myocardial infarction,acute
Electrocardiogram ST segment depression
Ischemia reperfusion
Myocardial protection
作者简介
通信作者:王伯良,E-mail:wliang@fmmu.edu.cn。
