前列腺素E1脂微球载体制剂治疗非ST段抬高心肌梗死的疗效分析

Analysis of the curative effect of Lipo-prostaglandin E1 on non-ST segment elevation myocardial infarction

目的 探讨前列腺索E1脂微球载体制剂（凯时）治疗非ST抬高心肌梗死（NSTEMI）的有效性与安全性.方法 入选86例NSTEMI患者随机分为治疗组（43例）和对照组（43例）,对照组给予低分子肝素、氯吡格雷、阿司匹林和其他基础治疗,治疗组在此基础上给予凯时,比较两组基础临床情况和疗效,30 d内主要心脏不良事件（MACEs）发生率（包括死亡、新近发生急性心肌梗死,靶血管血运重建）,出血并发症及其他不良反应.结果 两组基础临床情况相同;治疗组心绞痛缓解和缺血性心电图改善（95.3%和93.0%）均优于对照组（81.4%和74.4%）（x2=4.070、4.440,P＜0.05）.治疗组左心衰竭发生率和30 d内MACEs发生率（2.3%和4.7%）均低于对照组（14.0%和18.6%）（x2=4.962、4.077,P＜0.05）;两组均无肝肾功能损害等其他不良反应.结论 前列腺素E1能改善NSTEMI患者的临床症状、心肌灌注、心功能,减少30 d内主要心脏不良事件发生,疗效确切,安全性好.

Objective To investigate the efficacy and safety of Lipo-prostaglandin E1 （LipoPGE1） in the treatment of non-ST segment elevation acute myocardial infarction （NSTEAMI）.Methods A total of 86 patients with NSTEAMI were randomly and equally divided into LipoPGE1 group （n= 43） which received intravenous LipoPGE1 combined with low-molecular-weight heparin,aspirin, clopidogrel and other basic therapy, and the control group （n=43） which received placebo combined with the same therapy. The basic clinical settings, curative effect, main adverse cardiovascular events （MACEs） within 30 days including sudden death, new-onset myocardial infarction and target vessel revascularization, bleeding complications and drug adverse effects were observed. Results There were no significant differences in basic clinical characteristics between the two groups. Compared with control group, the patients in LipoPGE1 group showed. significant improvements of ECG （93.0% vs. 74.4%）, angina （95.3% vs. 81.4%, both P〈0. 05）, the incidences of left heart failure （2.3% vs. 14.0%） and MACEs within 30 days （4.7% vs.18.6%）（both P〈0.05）. There were no serious drug adverse effects. Conclusions The LipoPGE1 combined with heparin, aspirin and clopidogrel is effective and safe in the treatment of NSTEAMI,which could improve the clinical symptoms, distal myocardium perfusion and cardiac function,decrease the incidence of MACEs.