早期应用低分子肝素在急性心肌梗死患者溶栓治疗中的效果及对心功能的影响

Effect of early application of low molecular weight heparin in thrombolytic therapy for patients with acute myocardial infarction and its influence on cardiac function

目的探究早期应用低分子肝素在急性心肌梗死患者溶栓治疗中的效果及对心功能的影响。方法选取2017年6月至2018年6月我院收治的88例急性心肌梗死溶栓治疗患者作为研究对象,回顾性分析所有患者临床资料,根据不同的治疗方案将患者分为对照组和观察组,各44例。对照组在溶栓治疗12 h后用低分子肝素治疗,观察组于溶栓治疗前用低分子肝素治疗。比较两组的临床疗效、心功能、凝血指标及血清指标。结果治疗后,观察组治疗总有效率及血管再通率均高于对照组,差异有统计学意义(P<0.05);两组的左室射血分数均升高,且观察组高于对照组(P<0.05);两组的左室收缩末期内径及左室舒张末期内径均缩小,且观察组小于对照组(P<0.05);两组的血浆凝血酶时间、部分凝血活酶时间及凝血酶原时间均延长,且观察组长于对照组(P<0.05);两组的C反应蛋白和NT-ProBNP水平均升高,但观察组低于对照组(P<0.05)。结论在急性心肌梗死患者溶栓治疗中早期应用低分子肝素可提高临床疗效,改善心功能、凝血指标及血清指标,值得临床推广应用。

Objective To investigate the effect of early application of low molecular weight heparin in thrombolytic therapy of acute myocardial infarction and its influence on cardiac function. Methods A total of 88 patients with acute myocardial infarction treated by thrombolytic therapy in our hospital from June 2017 to June 2018 were selected as study objects. The clinical data of all patients were retrospectively analyzed. According to different treatment schemes, the patiens were divided into control group and observation group, with 44 cases in each group. The control group was treated with low molecular weight heparin after 12 hours of thrombolytic therapy, and the observation group was treated with low molecular weight heparin before thrombolytic therapy. The clinical efficacy, cardiac function, coagulation indexes and serum indexes in both groups were compared. Results After treatment, the total effective rate of treatment and vascular recanalization rate in the observation group were higher than those in the control group, and the differences were statistically significant (P<0.05);the left ventricular ejection fraction increased in both groups, and that in the observation group was higher than the control group (P<0.05);the left ventricular end systolic dimension and left ventricular end diastolic dimension reduced in both groups, and those in the observation group were lower than the control group (P<0.05);the plasma thrombin time, partial thromboplastin time and prothrombin time in both groups prolonged, and those in the observation group were longer than the control group (P<0.05);the levels of C-reactive protein and NT-ProBNP in both groups increased, but those in the observation group were lower than the control group (P<0.05). Conclusion Early application of low molecular weight heparin in thrombolytic therapy for acute myocardial infarction can enhance clinical efficacy, and reduce the cardiac function, blood coagulation index and serum indexes, which is worthy of clinical promotion and application.