水蛭注射液溶栓治疗急性心肌梗死临床观察

Clinical observation on treatment with leech injection(水蛭注射液) for acute myocardial infarction

目的 :探讨水蛭注射液溶栓治疗急性心肌梗死 (AMI)的疗效及对冠脉再通率的影响。方法 :42例患者随机分为 2组 ,常规治疗组 2 1例按 AMI常规治疗 ,水蛭组 2 1例在常规治疗的基础上 ,采用水蛭注射液 (皮试阴性 ) 6～ 10 ml加入 5 %葡萄糖氯化钠溶液 10 0 m l中静滴 ,1小时内滴完。于第 2～ 14日减量至 2～ 4ml/ d。结果 :水蛭组冠脉再通率为 38.10 % ,显著高于常规治疗组 (9.5 2 % ,P<0 .0 5 )。溶栓 6小时内水蛭组无一例死亡 ;6～ 12小时溶栓病死率水蛭组为 10 .0 0 % ,显著低于常规治疗组 (2 8.5 7% ,P<0 .0 5 )。且水蛭组无一例发生出血倾向或发热等过敏反应。结论 :早期应用水蛭注射液溶栓治疗 AMI,可明显提高冠脉再通率 ,降低病死率 ,有较好的溶栓效果。

Objective:To observe the solving thrombus effects and the influence of coronary artery reflowing of leech injection on acute myocardial infarction(AMI).Methods:42 patients were randomly divided into two groups.The ordinary treatment group ( n =21) was treated by ordinary therpay of AMI;leech treatment group combined with ordinary therapy and leech injection (skin test negative)610 ml diluted in 5% GNS 100 ml through venous gutta for one hour per day,then decreased to 24 ml per day from 2nd to 14th day. Results: The reflowing rate of coronary artery (38 10%)in leech treatment group was better than that (9 52%) in ordinary treatment group( P <0 05),there was no death in the course of solving thrombus in 6 hours;in 612 hours of the course of solving thrombus,the mortality(10 00%) in leech treatment group was markedly lower than that (28 57%) in ordinary treatment group ( P <0 05),while there was no heamorrhage or fever in leech treatment group.Conclusions:The solving thrombus therapy of leech injection in early stage can improve the reflowing rate of coronary artery,and decrease mortality with good solving thrombus effect.