依达拉奉治疗急性心肌梗死再灌注损伤的疗效观察

The Effect of edaravone on treatment of acute myocardial infarction and reperfusion injury

目的:探讨依达拉奉对急性心肌梗死再灌注损伤的治疗作用。方法:59例发病≤12h急性心肌梗死静脉溶栓治疗患者随机分为两组,观察组29例,为常规溶栓并应用依达拉奉;对照组30例,为常规溶栓治疗。记录心电监护4h内的心律失常类型,溶栓后4h内每1小时记录1次床边心电图,评价左室射血分数(LVEF),并记录Holter(记录Lown氏Ⅱ级以上室性心律失常患者数);登记住院1周以上死亡人数,住院天数等方面并作出统计、分析。结果:冠脉再通后4h内观察组出现再灌注心律失常20例(占69.0%);对照组出现再灌注心律失常28例(占93.3%)。观察组在治疗1～3周后左室射血分数为(58.2±5.3)%,对照组为(50.6±4.6)%;住院治疗1～3周后治疗组恶性心律失常发生率为13.8%,对照组为33.3%。两组再灌注心律失常发生率、恶性心律失常发生率、左室射血分数(LVEF),住院天数比较差异有统计学意义(P<0.05)。治疗组患者住院期间总体病死人数减少,但两组比较差异无统计学意义(P>0.05)。治疗期间治疗组无明显不良反应。结论:依达拉奉可降低急性心肌梗死,可减少缺血/再罐注(ischemia-reper-fusion,I/R)造成的心肌损伤,减少心律失常发病率,促进心功能恢复。

Objective：To discuss the therapeutical effect of edaravone on reperfusion injury in AMI（acute myocardial infarction）.Methods：Divided 59 patients with AMI less than twelve hours into two groups（controls and observation groups） randomly.We treated the observation group included 29 cases in conventional therapy with edaravone,and treated the control group which consisted of 30 patients in conventional therapy without edaravone.Then,the author made statistical analysis from recording the type of arrhythmia of ECG and the BSECG one time per hour after thrombolysis within 4 hours,evaluating the LVEF（left ventricular ejection fraction）,recording the Holter（recording the number of patients with Lown’s ventricular arrhythmias above grade Ⅱ） and the number of deaths who had been in hospital more than 1 week,etc.Results：In observation group,there were 20 cases（accounting for 69.0%） with coronary reperfusion within 4 hours after reperfusion arrhythmias.In controls,there were 28 cases（93.3%） with reperfusion arrhythmias.After 1-3 weeks’ treatment,the percent of observation group with LVEF was（58.2±5.3）%,while（50.6±4.6）% in controlled group.The percent of malignant arrhythmia in observation group was 13.8%,while 33.3% in controls.Between observation group and control group,there was statistically significant difference（P〈0.05） in the incidence of reperfusion arrhythmia and malignant arrhythmia,LVEF,and inpatient days as well.There was no significant difference in the percent of death between the two groups（P〉0.05）,although the number of death in observation group was less.The observation group didn’t have obvious adverse reactions in treatment.Conclusion：The use of edaravone can lower the acute myocardial infarction,reduses the myocardial injury caused by ischemia/reperfusion（Ischemia-reperfusion,I/R）.It can also reduce the incidence of arrhythmia and promote heart function.