磷酸肌酸钠治疗急性心肌梗死后室性心律失常疗效观察

Effect of creatine phosphate sodium in the treatment of ventricular arrhythmia after acute myocardial infarction

目的探讨磷酸肌酸钠对急性心肌梗死(AMI)后室性心律失常患者的治疗效果,并观察其对患者心功能的影响。方法选择2013年1月至2014年7月在本院诊治的96例AMI后室性心律失常患者,根据治疗方法分为对照组46例和观察组50例,对照组采用利多卡因等常规治疗;观察组在对照组基础上应用磷酸肌酸钠治疗。主要评估两组患者的治疗效果,以及治疗前后患者的左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)及左室收缩末容量(LVESV)等心功能指标。同时检测并比较其血清磷酸肌酸激酶同功酶(CK-MB)和B-型利钠肽(BNP)水平。结果观察组患者的治疗总有效率为94.00%(47/50),高于对照组的76.09%(35/46),差异有统计学意义(P<0.05);两组患者治疗后LVEF(%)均高于治疗前,LVEDD、LVESD和LVESV均低于治疗前,差异均有统计学意义(P<0.05)。观察组治疗后LVEF(%)为(0.51±0.10)%,高于对照组(0.48±0.08)%,差异具有统计学意义(P<0.05)。观察组治疗后LVEDD、LVESD和LVESV分别为(48.06±3.18)mm、(35.42±3.96)mm和(101.38±9.22)ml,均低于对照组治疗后(P<0.05)。两组治疗后CK-MB和BNP指标均低于治疗前,差异具有统计学意义(P<0.05)。观察组治疗后CK-MB和BNP分别为(49.25±8.64)U/L和(217.50±33.82)pg/ml,低于对照组的(61.47±7.60)U/L和(260.45±34.11)pg/ml,差异具有统计学意义(P<0.05)。结论磷酸肌酸钠对AMI后室性心律失常治疗效果较好,能够显著改善患者心功能,值得临床推广应用。

Objective To explore the effect of creatine phosphate sodium for ventricular arrhythmia after acute myocardial infarction （AMI）, and to observe the effects on cardiac function. Methods Ninety-six AMI patients with ventricular arrhythmia were randomly selected in our hospital from January 2013 to July 2014. According to treatment methods, they were divided into control group （46 cases） and observation group （50 cases）. The control group applied lidocaine and other conventional treatment, while the observation group added sodium phosphocrentine based on the control group. The clinical efficacy was evaluated, as well as left ventricular ejection fraction （LVEF）, left ventricu-lar end diastolic diameter （LVEDD）, left ventricular end systolic diameter （LVESD） and left ventricular end systolic volume （LVESV） before and after treatment. Levels of serum creatine kinase isoenzyme MB （CK-MB） and B-type natriuretic peptide （BNP） were detection and compared between the two groups. Results The total effective rate of the observation group was 94.00%（47/50）, significantly higher than 76.09%（35/46） of the control group （P〈0.05）. In the two groups, LVEF（%） after treatment were significantly higher than that before treatment, while LVEDD, LVESD and LVESV after treatment were significantly lower （P〈0.05）. LVEF（%） after treatment of the observation group was （0.51 ± 0.10）, significantly higher than （0.48 ± 0.08） of the control group （P〈0.05）. LVEDD, LVESD and LVESV of the observation group after treatment were （48.06±3.18） mm, （35.42±3.96） mm and （101.38±9.22） ml, respectively, significantly lower than those of the control group （P〈0.05）. CK-MB and BNP of two groups after treatment were lower than before treatment, and the difference was statistically significant （P〈0.05）. CK-MB and BNP of the observation group after treatment were （49.25 ± 8.64） U/L and （217.50 ± 33.82） pg/ml, significantly lower than those of the control group, （61.47±7.60） U/L and （260.45±34.11） pg/ml, and the differences were statistically significant （P〈0.05）. Conclusion Creatine phosphate sodium has significant effect on treating ventricular arrhythmia after AMI, which could significantly improve cardiac function and is worthy of clinical application.