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目的:探讨中青年急性心肌梗死合并心源性休克患者应用乌司他丁的短期疗效与安全性。方法:将2012年1月至2016年12月佛山市第二人民医院收治的109例中青年急性ST段抬高性心肌梗死合并心源性休克患者分为观察组(53例)和对照组(56例),两组均行急诊冠脉介入治疗(PCI),观察组联合使用乌司他丁治疗,而对照组则仅予常规治疗,比较两组术前术后血BNP、CtnI、左室射血分数、新发心脏瓣膜病变。结果:观察组首次查血BNP、CtnI、左室射血分数对照组无差别(P>0.05);术后7d的血BNP、Ctn I水平明显低于对照组(P<0.05),观察组7 d、30 d心脏超声提示左室射血分数明显高于对照组(P<0.05);新发心脏瓣膜病变发生率低于对照组(P<0.05)。结论:中青年急性心肌梗死合并心源性休克的患者,在急诊PCI的基础上,应用乌司他丁有利于减轻心肌损害,保护心功能,可能有助于改善中远期预后。
Objective: To investigate the short-term efficacy and safety of ulinastatin in middle-aged and young patients with acute myocardial infarction complicated by cardiogenic shock. Methods: A total of 109 middle-aged and young patients with ST-segment elevation myocardial infarction and cardiogenic shock admitted to the Second People’s Hospital of Foshan from January 2012 to December 2016 were divided into observation group (53 cases) and control group 56 cases). Both groups underwent emergency PCI, the observation group was treated with ulinastatin, while the control group was treated only routinely. The levels of BNP, CtnI, left ventricular Ejection fraction, new heart valve disease. Results: The levels of BNP, CtnI and left ventricular ejection fraction in the observation group were not significantly different from those in the control group (P> 0.05). The levels of BNP and Ctn I in the 7th day after operation were significantly lower than those in the control group (P <0.05) Cardiac echocardiography at 30 days showed that the left ventricular ejection fraction was significantly higher than that of the control group (P <0.05). The incidence of newly diagnosed valvular heart disease was lower than that of the control group (P <0.05). Conclusion: Ulinastatin can reduce myocardial damage and protect heart function in patients with middle-aged and young acute myocardial infarction complicated with cardiogenic shock. It may be helpful to improve the long-term prognosis.