论文部分内容阅读
目的 :探讨前列地尔脂肪乳剂 (Lipo PGE1)对急性心肌梗死 (AMI)溶栓后微循环再灌注的影响。方法 :首次发病 6h之内的AMI溶栓治疗判为临床再通者 5 6例分为 :对照组 ,2 4例 ;Lipo PGE1组 ,32例。后者溶栓前予Lipo PGE110 μg静脉注射 ,余治疗同对照组。统计 2h内心电图ST段抬高指数 (∑STI)下降≥ 5 0 %率与ST段完全回落率。测量溶栓前及溶栓后 2 4h的QRS积分。测定溶栓前即刻及溶栓后 2h、10h血小板聚集率。结果 :Lipo PGE1组与对照组比较 :①心电图∑STI下降≥ 5 0 %率、ST段完全回落率均显著提高 (96 .9%∶75 .0 % ,P <0 .0 5 ;84 .4 %∶5 8.3% ,P <0 .0 5 ) ;②溶栓后 2h两组血小板聚集率Lipo PGE1组明显低于对照组 [(31±18) %∶(4 5± 2 2 ) % ,P <0 .0 1],10h两组相同 [(15± 7) %∶(13± 6 ) % ,P >0 .0 5 ];③溶栓治疗后 2 4hLipo PGE1组QRS积分明显低于对照组 (5 .2± 0 .3∶5 .9± 0 .4 ,P <0 .0 5 )。结论 :Lipo PGE1能通过迅速抑制血小板功能 ,减轻心肌微循环的无复流现象 ,减少心肌梗死面积
Objective: To investigate the effect of lipo PGE1 on microcirculation and reperfusion after acute myocardial infarction (AMI) thrombolysis. Methods: Sixty-six cases of AMI thrombolytic therapy for the first time within 6 hours were divided into control group (24 cases) and Lipo PGE1 group (32 cases). The latter before thrombolysis Lipo PGE110 μg intravenously, the remaining treatment with the control group. Statistics 2h ECG ST segment elevation index (ΣSTI) decreased ≥ 50% rate and ST segment complete response rate. QRS scores were measured before and 24 hours after thrombolysis. The rate of platelet aggregation immediately before thrombolysis and 2h and 10h after thrombolysis were measured. Results: The Lipo PGE1 group compared with the control group: ① The ΣSTI of electrocardiogram decreased more than 50%, and the complete recovery rate of ST segment increased significantly (96.9%: 75.0%, P <0.05; 84.4 %: 8.3%, P <0.05). ② The platelet aggregation rate in Lipo PGE1 group was significantly lower than that in control group at 2h after thrombolysis (31 ± 18% vs 45 ± 22%, P (P <0.01), (10 ± 7)%, (13 ± 6)%, P> 0.05] at 10 hours; ③ The QRS scores of LIPo PGE1 group at 24 hours after thrombolytic therapy were significantly lower than those of control group (5 .2 ± 0 .3: 5 .9 ± 0.4, P <0.05). Conclusion: Lipo PGE1 can reduce the myocardial infarction area by rapidly inhibiting platelet function, reducing the no-reflow phenomenon of myocardial microcirculation