摘要
目的观察联合应用拜阿司匹林、血栓通粉针剂对治疗心肺复苏（CPR）成功患者的疗效及安全性。方法采用前瞻性临床随机对照研究方法，将CPR成功的患者按入院顺序分为研究组和对照组。研究组患者在CPR成功后常规口服拜阿司匹林100mg、每日1次，静脉滴注血栓通0．3g、12h1次，治疗15d；对照组患者给予常规治疗。于CPR后1、5、15、30d取静脉血，采用快速荧光免疫法检测N末端脑钠肽前体（NT-proBNP），并行心脏彩色超声观察心功能指标；于治疗12、24、48、72、96h测定肌酸激酶同工酶（CK-MB）。结果以复苏成功为始点，观察30d后为终点。研究组有8例因再次心功能衰竭死亡，对照组有13例因再次心功能衰竭死亡，研究组复苏后病死率明显低于对照组[25．8％（8／31）比35．1％（13／37），P〈0．01]。最终研究组人选23例，对照组入选24例。两组随治疗时间延长，左室心功能指标每搏量（sv）、左室射血分数（LVEF）、左室收缩期末内径（LVESD）、左室舒张期末内径（LVEDD）均明显好转，且研究组优于对照组[30dSV（m1）：65．4±8．4比61．1±9．0，LVEF：0．558±0．056比0．461±0．071，LVESD（mm）：45．7±5．2比41．3±5．8，LVEDD（mm）：99．7±9．1比91．1±8．9，均P〈0．05]。研究组静脉血NT-proBNP、CK-MB的恢复也明显优于对照组（P〈0．05或P〈0．01）。结论联合应用拜阿司匹林、血栓通能显著降低CPR成功后患者的病死率，提高CPR成功后患者的生存率及生存质量。
Objective To observe the safety and curative effect of combined therapy of aspirin （Bayer） tablet and Xueshuantong injection on patients with successful cardiopulmonary resuscitation （CPR）. Methods A prospective randomized clinical contrast method was conducted. Successful CPR patients were divided into a research group and a control group by admission time sequence. The research group patients were given routine therapy and orally took aspirin （Bayer） tablet, 100 mg once a day, and were injected Xueshuantong injection, 0.3 g, once every 12 hours, while the control group patients were only given routine therapy, the therapeutic course being 15 days in both groups. On 1, 5, 15, 30 days after CPR, venous blood was collected to quantitatively measure N-terminal probrain natriuretic peptide （NT-proBNP）by rapid fluorescence immunoassay method, and in the mean time, all patients accepted heart color Doppler ultrasound examination to observe the changes of heart function. At the 12th, 24th, 48th, 72th, 96th hour after CPR, the activity of creatine kinase isoenzyme MB （CK-MB） in blood was tested by immune suppression method. Results The research of observation began from the success of CPR, and its end was 30 days away from the day of CPR success. Only did 8 cases in the research group died of heart failure again in the 30 days, while in the control group, this number was 13 cases, the death rate of the research group being obviously lower than that in the control group [25.8% （8/31） vs. 35.1% （13/37）,P〈0.01]. Finally 23 cases were enrolled in research group, and 24 cases in control group. With prolongation of therapy, the stroke volume （SV）, left ventricular ejection fraction （LVEF）, left ventricular end systolic diameter （LVESD）, left ventricular end diastolic diameter （LVEDD） of the patients in the two groups improved significantly, and the improvement was better in the research group than that in the control group [30 days SV （ml） ： 65.4±8.4 vs. 61.1±9.0, LVEF ： 0.558±0.056 vs. 0.461±0.071, LVESD （mm） ： 45.7±5.2 vs. 41.3±5.8, LVEDD （mm） ： 99.7±9.1 vs. 91.1±8.9, all P〈0.05]. The improvement of venous blood NT-proBNP and CK-MB in the research group was also much better than that in the control group （P〈0.05 or P〈0.01）. Conclusion The combined therapy of aspirin （Bayer） tablet and Xueshuantong injection not only can remarkably decrease the death rate of patients who have obtained successful CPR, but also improve survival rate and quality of life.
出处
《中国中西医结合急救杂志》
CAS
北大核心
2012年第6期340-342,共3页
Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care
基金
河南省医学科技攻关计划项目（200903127）
关键词
心肺复苏
拜阿司匹林
血栓通
N末端脑钠肽前体
肌酸激酶同工酶
Cardiopulmonary resuscitation
Aspirin
Xueshuantong injection
N terminal pro-brain natriuretic peptide
Creatine kinase isoenzyme MB
