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目的 :用99m锝 甲氰基异丁基晴心肌灌注断层显像 (SPECT) ,评价参麦注射液对急性心肌梗死 (AMI)尿激酶 (UK)溶栓治疗再灌注心肌保护作用的临床疗效。方法 :537例AMI患者随机分为两组 ,参麦组 ( 2 92例 )采用UK溶栓疗法和参麦注射液治疗 ,对照组 ( 2 4 5例 )只使用UK溶栓疗法。于溶栓治疗后第7日进行SPECT检测。对两组心肌缺血面积 (IMA)和左室射血分数 (EF)的变化进行对比研究。结果 :参麦组和对照组梗塞相关血管 (IRA)再通率之间差异无显著性 (分别为 72 2 6%、72 65% ,P >0 0 5)。参麦组IRA再通患者 ( 2 11例 )的IMA显著低于对照组IRA再通患者 ( 178例 ,P <0 0 1)。参麦组IRA未通患者( 81例 )的IMA与对照组 ( 67例 )比较 ,亦显著降低 (P <0 0 5)。参麦组EF显著高于对照组 (P <0 0 1)。结论 :在AMIUK溶栓治疗早期使用参麦注射液可显著缩减IMA ,提高EF。参麦注射液对AMI溶栓再灌注心肌具有良好的保护作用
Objective: To evaluate the clinical effect of Shenmai injection on cardioprotection of acute myocardial infarction (AMI) urokinase (UK) thrombolytic therapy after myocardial perfusion with 99m technetium-cyano-isocyanide clear myocardial perfusion imaging (SPECT). Methods: 537 AMI patients were randomly divided into two groups. The Shenmai group (2 92 cases) received UK thrombolysis and Shenmai injection. The control group (245 cases) received UK thrombolysis alone. SPECT was performed on the 7th day after thrombolytic therapy. The changes of myocardial ischemia area (IMA) and left ventricular ejection fraction (EF) in two groups were compared. Results: There was no significant difference in the recanalization rate of IRA between Shenmai group and control group (72.26% and 72.65%, P> 0.05). The IMA of recurrent patients with IRA in Shenmai group was significantly lower than that of control group (178 cases, P <0.01). The IMA of the non-IRA patients (81 cases) in the Shenmai group was also significantly lower than that in the control group (67 cases) (P <0.05). Shen Mai EF group was significantly higher than the control group (P <0.01). Conclusion: The use of Shenmai injection in the early stage of AMIUK thrombolytic therapy can significantly reduce IMA and improve EF. Shenmai injection on AMI thrombolysis and reperfusion myocardial has a good protective effect