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果糖二磷酸钠治疗急性心肌梗死的临床研究
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| 篇名： | 果糖二磷酸钠治疗急性心肌梗死的临床研究 |
| TITLE： | |
| 摘要： | 目的：探讨果糖二磷酸钠对急性心肌梗死（AMI）患者心功能、心肌损伤标志物、缺血修饰白蛋白（IMA）、和肽素的影响及安全性。方法：采用回顾性研究方法，选择2014年2月－2015年4月在南阳市第二人民医院接受治疗的102例AMI患者的临床资料，按治疗方案不同分为观察组和对照组，各51例。两组患者均行基础治疗，并给予尿激酶静脉滴注+肝素静脉泵注+阿司匹林口服等对症治疗方案。观察组患者在此基础上联用注射用果糖二磷酸钠10 g静脉滴注，bid。两组患者均连续治疗7～10 d。记录两组患者治疗前后左室舒张末期内径（LVDd）、左室收缩末期内径（LVSd）、左室射血分数（LVEF）等心功能指标，心肌肌钙蛋白Ⅰ（cTnⅠ）、肌酸激酶同工酶（CK-MB）等心肌损伤标志物及IMA、和肽素等指标变化情况，心功能分级情况，以及不良反应和不良事件发生情况。结果：治疗前，两组患者上述指标比较，差异均无统计学意义（P＞0.05）。治疗后12、24 h，两组患者的LVDd、LVSd较治疗前显著缩短，LVEF、IMA水平较治疗前显著升高，CK-MB、和肽素水平较治疗前显著降低，且观察组患者的改善幅度均显著大于对照组同期，差异均有统计学意义（P＜0.05）；两组患者的cTnⅠ水平较治疗前逐渐提升[观察组患者治疗后12 h与治疗前比较差异无统计学意义（P＞0.05）]，但观察组患者的增幅显著小于对照组同期，差异均有统计学意义（P＜0.05）。治疗后24 h，观察组患者心功能Killip分级的Ⅰ～Ⅱ级率为96.1％，显著高于对照组的78.4％，差异有统计学意义（P＜0.05）。两组患者均未见严重的不良反应发生，不良反应发生率比较差异无统计学意义（P＞0.05）；在不良事件方面，两组患者除死亡率比较差异无统计学意义（P＞0.05）外，观察组患者发生严重心律失常、再发心肌梗死、梗死后心绞痛等不良事件的例数及总发生率均显著少于或低于对照组，差异有统计学意义（P＜0.05）。结论：在常规对症治疗基础上联用果糖二磷酸钠治疗AMI，可有效提升心肌损伤标志物、IMA及和肽素水平，改善患者心功能，降低不良事件发生风险，从而提升预后质量。 |
| ABSTRACT： | OBJECTIVE： To investigate the effects and safety of fructose sodium diphosphate on cardiac function， myocardial injury markers， ischemia modified albumin （IMA） and copeptin in patients with acute myocardial infarction （AMI）. METHODS： In retrospective study， 102 AMI patients were collected from Nanyang Second People’s Hospital during Feb. 2014-Apr. 2015， and then divided into observation group and control group according to therapy plan， with 51 cases in each group. Both groups received routine therapy and symptomatic therapy as intravenous dripping of urokinase+ intravenous pump of heparin+oral administration of aspirin. Observation group was additionally given fructose sodium diphosphate 10 g intravenously， bid. Treatment courses of 2 groups lasted for 7-10 d. The changes of cardiac function indexes （LVDd， LVSd， LVEF）， myocardial injury markers （cTnⅠ， CK-MB）， IMA and copeptin were recorded in 2 groups before and after treatment. The cardiac function grading， the occurrence of ADR and adverse events were also recorded in 2 groups. RESULTS： Before treatment， there was no statistical significance in above indexes between 2 groups （P＞0.05）. 12， 24 h after treatment， LVDd and LVSd of 2 groups were shortened significantly， while LVEF and IMA levels were increased significantly， and CK-MB and copeptin levels were decreased significantly， compared to before treatment； the improvement of observation group was significantly better than control group， with statistical significance （P＜0.05）. cTnⅠ levels of 2 groups were increased gradually compared to before treatment [there was no statistical significance in observation group between 12 h after treatment and before treatment （P＞0.05）]； the increase of observation group was significantly smaller than that of control group， with statistical significance （P＜0.05）. 24 h after treatment， the proportion of cardiac function Killip gradeⅠ-Ⅱ was 96.1％ in observation group， which significantly higher than 78.4％ in control group， with statistical significance （P＜0.05）. No severe ADR was found in 2 groups， and there was no statistical significance in the incidence of ADR （P＞0.05）. In respect of adverse events， the number of adverse events as severe arrhythmia， recurrent myocardial infarction， postinfarction angina pectoris and total incidence of ADE in observation group was significantly less or under than control group， with statistical significance （P＜0.05）， besides there was no statistical significance in mortality between 2 groups （P＞0.05）. CONCLUSIONS： Routine symptomatic treatment combined with sodium fructose diphosphate in the treatment of AMI can effectively increase myocardial injury markers， copeptin and IMA levels， improve cardiac function and reduce the risk of adverse events so as to improve the quality of prognosis. |
| 期刊： | 2017年第28卷第8期 |
| 作者： | 白延涛，石全宝，李燕 |
| AUTHORS： | BAI Yantao，SHI Quanbao，LI Yan |
| 关键字： | 果糖二磷酸钠；急性心肌梗死；心肌损伤标志物；缺血修饰白蛋白；和肽素；心功能 |
| KEYWORDS： | Sodium fructose diphosphate； Acute myocardial infarction； Myocardial injury markers； Ischemia modified albumin； Copeptin； Cardiac function |
| 阅读数： | 335 次 |
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