|
|
|
| Application effect of early low molecular weight heparin anticoagulation therapy for thrombolysis in patients with acute myocardial infarction |
| JIN Dapeng1 WANG Wenfeng1▲ ZHAO Xiujuan2 LI Yanhong3 |
1.Department of Cardiovascular Medicine, Affiliated Hospital of Chengde Medical College, Hebei Province, Chengde 067000, China;
2.Department of Infectious Diseases, Langfang People′s Hospital of Hebei Province, Hebei Province, Langfang 065000, China;
3.Centers for Disease Control and Prevention of Longhua County, Hebei Province, Longhua 068150, China |
|
|
|
Abstract Objective To probe into the clinical application value of early low molecular weight heparin anticoagulation therapy for thrombolysis in patients with acute myocardial infarction. Methods From January 2014 to December 2015, 118 patients with acute myocardial infarction were selected in Affiliated Hospital of Chengde Medical College were selected as study objects. The patients were divided into treatment group (n=60) and control group (n=58) by random number table method. The patients in treatment group were treated with low molecular weight heparin before thrombolytic therapy. The patients in control group were treated with low-molecular-weight heparin 12 hours after thrombolytic therapy. The situation of recanalization, the level of inflammatory factors and adverse reactions of the patients with acute myocardial infarction in two groups were compared. Results Compared with control group, the recanalization rate of treatment group was significantly improved, and recanalization time of treatment group was further shortened, the differences were statistically significant (P < 0.05). Compared with before treatment, the levels of tumor necrosis factor α (TNF-α), interleukin 6 (IL-6) and hypersensitive C-reactive protein (hs-CRP) were significantly decreased in two groups after treatment, the differences were statistically significant (P < 0.05). Compared with control group after treatment, the levels of TNF-α, IL-6 and hs-CRP in treatment group were significantly lower than those in control group, the differences were statistically significant (P < 0.05). There was no significant difference in total incidence of adverse reactions such as gingival bleeding, subcutaneous hemorrhage and upper gastrointestinal bleeding in two groups (P > 0.05). Conclusion Early application of low molecular weight heparin anticoagulant therapy has very important clinical value in regulating of cell inflammatory cytokines effectively, improving the rate of recanalization and shorting the recanalization time fundamentally for thrombolysis in patients with acute myocardial infarction.
|
|
|
|
|
|
[1] 杨新春.急性冠状动脉综合征[M].北京：人民卫生出版社，2009：20-21.
[2] Koklu E，Kus G，Yuksel IO，et al. Successful thrombolytic therapy for ST-elevation acute myocardial infarction in a patient with immune thrombocytopenic purpura [J]. Am J Emerg Med，2016，34（2）：345-353.
[3] Ornek E，Duran M，Ornek D，et al. The effect of thrombolytic therapy on QT dispersion in acute myocardial infarction and its role in the prediction of reperfusion arrhythmias [J]. Niger J Clin Pract，2014，17（2）：183-187.
[4] 于晓羽，代倩，程淑群，等.溶栓前肝素治疗对急性心肌梗死溶栓疗效的系统评价[J].中国循证医学杂志，2014， 14（3）：277-276.
[5] 葛均波.内科学[M].8版.北京：人民卫生出版社，2013：382-383.
[6] Cavallari I，Bonaca MP. Antiplatelet therapy for secondary prevention after acute myocardial infarction [J]. Interv Cardiol Clin，2017，6（1）：119-129.
[7] 李秀英.急性心肌梗死溶栓治疗中早期应用低分子肝素抗凝治疗的临床疗效[J].中外医学研究，2013，11（7）：29-30.
[8] 肖卫田.早期应用低分子肝素对急性心肌梗死患者溶栓疗效的影响[J].中国药物经济学，2015（11）：45-46.
[9] 刘睦胜.急性心肌梗死急诊介入中应用血栓抽吸联合冠脉内注射盐酸替罗非班的效果分析[J].中国当代医药，2016，23（33）：37-39.
[10] 刘睦胜，樊华，吴爱云.冠状动脉内注射替罗非班治疗急性心肌梗死介入术中慢或无复流现象的临床研究[J].中国当代医药，2016，23（30）：41-43.
[11] 张景文，程王生.血栓抽吸在急性心肌梗死中的应用[J].中国当代医药，2016，23（16）：50-52.
[12] Rama M，Miraci M，Balla I，et al. Cost-effectiveness of thrombolytic therapy，compared with anticoagulants therapy in the treatment of acute myocardial infarction in albania [J]. Open Access Maced J Med Sci，2015，3（2）：341-344.
[13] 曹华政.尿激酶静脉溶栓联合低分子肝素钙治疗急性心肌梗死疗效观察[J].右江民族医学院学报，2016，38（1）：41-42，50.
[14] 张鹏，郭慧，钟诚.强化溶栓治疗对急性心肌梗死患者凝血功能及出血风险的影响[J].血栓与止血学，2017， 23（1）：49-51.
[15] Puymirat ?魪，Aissaoui N，Silvain J，et al. Comparison of bleeding complications and 3-year survival with low-molecular-weight heparin versus unfractionated heparin for acute myocardial infarction：the FAST-MI registry [J]. Arch Cardiovasc Dis，2012，105（6）：347-354.
[16] 丁洪涛，周军.低分子肝素抗凝治疗在急性心肌梗死溶栓中早期应用的临床观察[J].陕西医学杂志，2012，41（4）：414-416.
[17] K?覦rba?鬤 ?觟，Kurmu?鬤 ?觟，K?觟seo■lu C，et al. Association between admission mean platelet volume and ST segment resolution after thrombolytic therapy for acute myocardial infarction [J]. Anadolu Kardiyol Derg，2014，14（8）：728-732.
[18] 杜相鹏，于云.瑞替普酶与低相对分子质量肝素早期溶栓治疗急性心肌梗死的对比研究[J].血栓与止血学，2013， 19（6）：251-253.
[19] 杜秀娟，李旭文.早期应用低相对分子质量肝素在急性心肌梗死瑞替普酶溶栓治疗中的疗效观察[J].哈尔滨医药，2014，34（3）：203-204.
[20] Duan J，Yang Y，Liu H，et al. Osthole ameliorates acute myocardial infarction in rats by decreasing the expression of inflammatory-related cytokines，diminishing MMP-2 expression and activating p-ERK [J]. Int J Mol Med，2016， 37（1）：207-216.
[21] Prondzinsky R，Unverzagt S，Lemm H，et al. Acute myocardial infarction and cardiogenic shock：prognostic impact of cytokines：INF-γ，TNF-α，MIP-1β，G-CSF，and MCP-1β [J]. Med Klin Intensivmed Notfmed，2012，107（6）：476-484.
[22] Anderson DR，Poterucha JT，Mikuls TR，et al. IL-6 and its receptors in coronary artery disease and acute myocardial infarction [J]. Cytokine，2013，62（3）：395-400.
[23] Nozari Y，Geraiely B. Correlation between the serum levels of uric acid and hs-CRP with the occurrence of early systolic failure of left ventricle following acute myocardial infarction [J]. Acta Med Iran，2011，49（8）：531-535.
[24] 胡大军，刘剑萍，廖昆，等.低分子肝素对兔动脉粥样硬化易损斑块模型血清CRP、IL-6的影响[J].中国老年学杂志，2013，33（18）：4468-4469. |
|
|
|
