参附注射液治疗急性下壁右室心肌梗死术后心衰临床观察

Intervention Effect of Shenfu Injection Combined with Pulmonary Ultrasound on Acute Inferior Right Ventricular Myocardial Infarction

目的观察参附注射液结合肺部超声治疗急性下壁右室心肌梗死的疗效并探讨其作用机制及安全性。方法80例患者以随机数字表法随机分为对照组与观察组各40例。对照组单纯采用西医常规治疗,观察组在对照组的基础上予加用参附注射液。两组均采用床旁肺部超声及下腔静脉超声指导治疗,观察两组患者在治疗过程中肺部超声彗星尾征(ULCs)、症状性心衰的发生率及CCU住院天数,并在1周后观察两组患者心室射血分数(LVEF)及肾功能指标。结果观察组CCU住院天数、b线的数目均少于对照组(均P<0.05)。观察组症状性心力衰竭发生率30.00%,低于对照组的55.00%(P<0.05)。两组治疗前肌酐、LVEF值比较,差别均不大(P>0.05)。观察组治疗后肌酐值与治疗前比较,差别不大(P>0.05);对照组治疗后肌酐高于治疗前(P<0.05),且治疗后对照组肌酐高于观察组(P<0.05)。两组治疗后LVEF值均高于治疗前,且观察组LVEF值高于对照组(均P<0.05)。结论参附注射液辅助治疗急性下壁右室心肌梗死能够改善患者的心功能,减少症状性心衰发生率,减少CCU住院天数。

Objective:To evaluate the efficacy and safety of Shenfu Injection combined with pulmonary ultrasound in the treatment of acute inferior right ventricular myocardial infarction. Methods:80 patients were randomly divided into two groups with 40 cases in each group by using random comparison table method. The control group was treated with conventional western medicine,and the observation group was treated with Shenfu Injection on the basis of the control group. Bedside pulmonary ultrasound and inferior vena cava ultrasound were used to guide treatment in both groups. The ultrasound lung comets(ULCs),incidence of symptomatic heart failure and length of hospital stay in CCU of patients in both groups were observed during treatment. Left ventricular ejection fraction(LVEF)and renal function indexes of patients in both groups were observed 1 week later. Results:The incidence of symptomatic heart failure was 30.00% in the observation group and 55.00% in the control group,which was significantly lower(P < 0.05). ULCs number and CCU hospitalization days in the observation group were significantly lower than ULCs number and CCU hospitalization days in the control group(P < 0.05). The LVEF after treatment in the observation group was better than the control group(P < 0.05). The creatinine after treatment in the observation group was significantly lower than the control group(P < 0.05). Conclusion:Shenfu Injection can improve the cardiac function of patients with acute inferior right ventricular myocardial infarction,reduce the incidence of symptomatic heart failure,and reduce the length of CCU hospitalization.