目的 观察丹红注射液联合盐酸替罗非班治疗急性冠状动脉综合征的临床疗效。方法 选取2013年9月—2015年9月延安大学咸阳医院心内科收治的急性冠状动脉综合征患者86例,按照治疗方案不同将患者分为对照组和治疗组,每组各43例。对照组在基础治疗的基础上静脉滴注注射用盐酸替罗非班,起始剂量是0.4 μg/(kg·min),30 min内注射完毕,静脉维持量为0.1 μg/(kg·min),维持24 h,并经急诊行PCI术。治疗组在对照组治疗的基础上静脉滴注丹红注射液,40 mL加入5%葡萄糖注射液100 mL稀释后缓慢滴注,1次/d。两组患者均连续治疗14 d。观察两组的临床疗效,同时比较两组左心射血分数(LVEF)、左室舒张末期内径(LVEDD)和左室收缩末期内径(LVESD)的变化。观察两组ST段回落情况和出血情况,比较两组再发心绞痛、新发心肌梗死、顽固性心肌缺血等主要不良心血管事件的发生情况。结果 治疗后,对照组和治疗组的总有效率分别为76.74%、93.02%,两组比较差异有统计学意义(P<0.05)。治疗后,两组患者LVEF、LVEDD、LVESD均显著升高,同组治疗前后差异具有统计学意义(P<0.05);且治疗组这些观察指标的改善程度优于对照组,两组比较差异具有统计学意义(P<0.05)。对照组ST段回落率为65.12%,治疗组为83.72%,两组比较差异有统计学意义(P<0.05);对照组和治疗组出血发生率分别为13.95%、11.63%,两组比较差异无统计学意义。两组不良心血管事件总发生率分别为13.95%、2.33%,两组比较差异具有统计学意义(P<0.05)。结论 丹红注射液联合盐酸替罗非班治疗急性冠状动脉综合征疗效较好,有利于心功能的改善,能够降低心脏不良事件的发生率,具有一定的临床推广应用价值。

Objective To observe the clinical effect of Danhong Injection combined with tirofiban hydrochloride in treatment acute coronary syndrome. Methods Patients (86 cases) with acute coronary syndrome were enrolled in this study from September 2013 to September 2015. According to the different treatment plan, patients were divided into treatment group (43 cases) and control group (43 cases). The patients in the control group were iv administered with Tirofiban Hydrochloride for injection on the basis of foundation treatment, and the starting dosage was 0.4 μg/(kg·min) in 30 min, and the maintain dosage of iv was 0.1 μg/(kg·min) for 24 h. They were administered with emergency PCI. The patients in the treatment group were po administered with Danhong Injection on the basis of control group, 40 mL Danhong Injection added into 100 mL 5% Glucose Injection, once daily. The patients in two groups were treated for 14 d. After treatment, the clinical efficacy were evaluated, and the changes of LVEF, LVEDD, and LVESD in two groups were compared. The situations of ST segment decline and bleeding in two groups were observed. The occurrences of major adverse cardiac events such as recurrence angina pectoris, new myocardial infarction, and stubborn heart deficiency in two groups were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 76.74% and 93.02%, respectively, and there were differences between two groups (P < 0.05). After treatment, LVEF, LVEDD, and LVESD in two groups were significantly elevated, and the difference was statistically significant in the same group (P < 0.05). After treatment, the observational indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups (P < 0.05). The ST segment fell back rate in the control group was 65.12%, and that in the treatment groups was 83.72%, with significant difference between two groups (P < 0.05). The incidences of bleeding in the control and treatment group were 13.95% and 11.63%, respectively, and there was no statistically significant difference between two groups. The incidence rates of adverse cardiovascular events in two groups were 13.95% and 2.33%, respectively, with significant difference between two groups (P < 0.05). Conclusion Danhong Injection combined with tirofiban hydrochloride has clinical curative effect in treatment acute coronary syndrome, and can improve heart function, and can reduce the incidence of cardiac adverse events, which has a certain clinical application value.