目的:观察尿激酶联合卡托普利治疗老年急性心肌梗死(AMI)的临床疗效。方法选取2012年12月—2015年1月佛山市第一人民医院收治的老年 AMI 患者120例,按照治疗方法分为对照组和研究组,每组60例。对照组患者予以尿激酶静脉注射,研究组患者在对照组治疗基础上予以卡托普利治疗。比较两组患者治疗后胸痛消失时间、胸痛复发时间、白细胞计数(WBC)、中性粒细胞分数(NEUT)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白 I (cTnI)及治疗前后心脏指数(CI)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、Barthel 指数(BI)、改良 Rankin 量表评分,同时记录两组患者治疗期间不良反应发生情况。结果研究组患者胸痛消失时间短于对照组,胸痛复发时间长于对照组,WBC、NEUT、CK-MB及 cTnI 低于对照组(P ﹤0.01)。两组患者治疗前 CI、LVEF、LVEDD 及 LVESD 比较,差异均无统计学意义(P ﹥0.05);研究组患者治疗后 CI、LVEF高于对照组,LVEDD、LVESD 小于对照组(P ﹤0.05)。两组患者治疗前 BI、改良 Rankin 量表评分比较,差异无统计学意义(P ﹥0.05);研究组患者治疗后 BI 高于对照组,改良 Rankin 量表评分低于对照组(P ﹤0.05)。研究组患者治疗期间不良反应发生率为6.7%,低于对照组的26.7%(P ﹤0.01)。结论尿激酶联合卡托普利治疗老年 AMI 的临床疗效确切,可快速缓解患者临床症状,改善患者心功能及生活质量。
Objective To observe the clinical effect of urokinase combined with captopril on aged acute myocardial infarction. Methods A total of 120 elderly patients with acute myocardial infarction were selected in the First People's Hospital of Foshan from December 2012 to January 2015,and they were divided into control group and study group according to therapeutic methods,each of 60 cases. Patients of control group were given intravenous injection of urokinase,while patients of study group were given intravenous injection of urokinase combined with captopril. Chest pain disappeared time,chest pain recurrence time,WBC,NEUT,CK-MB and cTnI after treatment,CI,LVEF,LVEDD,LVESD,BI and modified Rankin scale score before and after treatment were compared between the two groups,and incidence of adverse reactions during treatment was recorded. Results Chest pain disappeared time of study group was statistically significantly shorter than that of control group,chest pain recurrence time of study group was statistically significantly longer than that of control group,WBC,NEUT, CK-MB and cTnI of study group were statistically significantly lower than those of control group( P ﹤ 0. 05). No statistically significant differences of CI,LVEF,LVEDD or LVESD was found between the two groups before treatment(P ﹥ 0. 05);after treatment,CI and LVEF of study group were statistically significantly higher than those of control group,while LVEDD and LVESD of study group were statistically significantly lower than those of control group( P ﹤ 0. 05). No statistically significant differences of BI or modified Rankin scale score was found between the two groups(P ﹥ 0. 05);after treatment,BI of treatment group was statistically significantly higher that of control group,while modified Rankin scale score of study group was statistically significantly lower than that of control group(P ﹤ 0. 05). The incidence of adverse reactions during treatment of study group was 6. 7% ,was statistically significantly lower than that of control group 26. 7% ( P ﹤ 0. 01). Conclusion Urokinase combined with captopril has certain clinical effect on aged acute myocardial infarction,can quickly relieve the clinical symptoms, effectively improve the cardiac function and quality of life.