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目的评价川芎嗪注射液后处理治疗急性ST段抬高型心肌梗死(STEMI)的有效性及安全性。方法将100例STEMI并接受经皮冠状动脉介入术的患者随机分为对照组和试验组各50例。对照组球囊扩张后予盐酸替罗非班氯化钠注射液10μg/kg冠状动脉内注射,术后连续0.2 mg/h静脉泵入48 h。试验组球囊扩张后给予盐酸替罗非班注射液10μg/kg冠状动脉内注射后,用川芎嗪注射液20 mg冠状动脉内注射,术后在对照组治疗基础上,加用盐酸川芎嗪注射液80 mg/d静脉滴注7天。比较两组治疗前后心电图ST段抬高幅度、肌酸激酶(CK)、肌酸激酶MB同工酶(CK-MB)、磷脂酶A2、冠脉校正TIMI帧数(CTFC)、左室射血分数(LV-EF)、血小板聚集功能测定(PAG%),并观察不良反应。结果试验组总有效率为93.6%,显著高于对照组83.3%(P=0.033)。治疗后两组CTFC、PAG%、ST段抬高幅度及CK、CK-MB、磷脂酶A2水平均明显下降,LV-EF水平显著上升(P<0.01),且试验组CTFC、PAG%、ST段抬高幅度及CK-MB、磷脂酶A2水平均明显低于对照组(P<0.05或P<0.01)。两组患者均无明显不良反应。结论川芎嗪注射液后处理治疗STEMI疗效确切,可减少心肌损伤,安全性较好。
Objective To evaluate the efficacy and safety of ligustrazine injection in the treatment of acute ST-segment elevation myocardial infarction (STEMI). Methods A total of 100 STEMI patients undergoing percutaneous coronary intervention were randomly divided into control group and trial group. The rabbits in the control group were given intraperitoneal injection of 10μg / kg tirofiban sodium chloride injection after balloon dilatation, and were continuously injected with 0.2 mg / h intravenously for 48 hours after operation. After balloon dilation, the experimental group was injected with 10 μg / kg TILF injection intracoronary injection and injected with ligustrazine 20 mg intracoronary injection. On the basis of the control group, the rats were treated with tetramethylpyrazine hydrochloride Liquid 80 mg / d intravenously for 7 days. The changes of ST segment elevation, CK-MB, CK-MB, CTFA, CTF, left ventricular ejection fraction Score (LV-EF), platelet aggregation function (PAG%), and observed adverse reactions. Results The total effective rate of the experimental group was 93.6%, which was significantly higher than that of the control group (83.3%) (P = 0.033). After treatment, CTFC, PAG%, ST segment elevation, CK, CK-MB and phospholipase A2 levels in both groups were significantly decreased and LV-EF levels were significantly increased (P <0.01) Segment elevation and CK-MB, phospholipase A2 levels were significantly lower than the control group (P <0.05 or P <0.01). No significant adverse reactions in both groups. Conclusion Ligustrazine injection treatment of STEMI exact effect, can reduce myocardial injury, safety is better.