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Objective: To evaluate the myocardial protecting effect of Shenmai injection (SMI) against ischemia/reperfusion injury in thrombolytic therapy with urokinase (UK) for acute myocardial infarction patients by 99mTc-MIBI myocardial imaging (SPECT). Methods: Five hundred and thirty-seven patients were divided into two groups randomly. The SMI group (n=292) was treated with thrombolytictreatment plus SMI and the control group (n=245) with thrombolytic treatment solely. Single photon emission computed tomography (SPECT) was carried out on the 7th day after thrombolysis to determine the ischemic myocardial area (IMA) and ejection fraction (EF) in both groups and compared. Results: The infarction related area (IRA) of reperfusion rate in the two groups was not different significantly (72.26% vs 72.65%, P >0.05). The IMA in patients of the SMI group, no matter with or without reperfused IRA (211 cases and 81 cases) respectively, was significantly lower than that in the control group (178 cases and 67 cases) respectively, P<0.01 and P<0.05 respectively. The EF value in the SMI group was significantly higher than that in the control group (P<0.01). Conclusion:Using SMI in early stage of thrombolytic treatment in acute myocardial infarction could significantly reduce IMA and increase EF. SMI showed good protective effect against myocardial ischemia/reperfusion injury in thrombolytic treatment.
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Objective: To evaluate the myocardial protecting effect of Shenmai injection (SMI) against ischemia/reperfusion injury in thrombolytic therapy with urokinase (UK) for acute myocardial infarction patients by 99mTc-MIBI myocardial imaging (SPECT). Methods: Five hundred and thirty-seven patients were divided into two groups randomly. The SMI group (n=292) was treated with thrombolytictreatment plus SMI and the control group (n=245) with thrombolytic treatment solely. Single photon emission computed tomography (SPECT) was carried out on the 7th day after thrombolysis to determine the ischemic myocardial area (IMA) and ejection fraction (EF) in both groups and compared. Results: The infarction related area (IRA) of reperfusion rate in the two groups was not different significantly (72.26% vs 72.65%, P >0.05). The IMA in patients of the SMI group, no matter with or without reperfused IRA (211 cases and 81 cases) respectively, was significantly lower than that in the control group (178 cases and 67 cases) respectively, P<0.01 and P<0.05 respectively. The EF value in the SMI group was significantly higher than that in the control group (P<0.01). Conclusion:Using SMI in early stage of thrombolytic treatment in acute myocardial infarction could significantly reduce IMA and increase EF. SMI showed good protective effect against myocardial ischemia/reperfusion injury in thrombolytic treatment.
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急性心肌梗塞溶栓冠状动脉开通临床无创指标价值的再探讨(摘要)
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超越rt-PA溶栓治疗"时间窗"
1995年新英格兰杂志发表了美国国立神经疾病及脑卒中研究院脑卒中研究(NINDS Ⅰ & Ⅱ),同年欧洲合作组急性脑卒中研究(ECASS Ⅰ & Ⅱ)和北美多个国家联合研究(ATLANTIS A & B)也相继发表.
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影响动脉溶栓治疗基底动脉闭塞疗效的因素
对于基底动脉闭塞的患者,如果采取传统的降纤、抗凝和抗血小板治疗,病死率高达80/~90/[1-2].尽管20世纪80年代早期已经开展基底动脉闭塞的动脉溶栓治疗,但目前有关文献报道不多,在国内笔者尚未检索到相关文献.
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溶栓治疗新进展——来自欧洲卒中会议及近期的报道
静脉溶栓治疗脑梗死的比例在国际上逐渐增高.2008年欧渊卒中会议上,荷兰鹿特丹M Dirks等对急性脑梗死24小时内入院的5 517例脑梗死患者进行研究,4小时以内入院1 658例,这些人中得到溶栓治疗的患者达698例,占全部患者的12%.
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Following an acute myocardial infarction (AMI), patients have an increased risk of stroke. Estimates of risk are mainly derived from AMI treatment trials or secondary prevention studies. The reported incidence of stroke in Caucasians in the early phase after AMI ranged from 0.5% to 2.5%.1-3 Similar assessment of risk in the Chinese population is lacking. As thrombolytic therapy becomes standard treatment for AMI, there is concern that there may be an increase in haemorrhagic stroke complicating AMI treatment, especially since haemorrhagic stroke is more common in Asian populations.
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急性心肌梗死致心跳骤停心肺复苏后急诊溶栓成功一例
1 资料与方法患者,男性,50岁.主因上腹部闷痛伴大汗0.5 h就诊于某基层医院,当时确诊为急性前壁、高侧壁大面积心肌梗死(MI).
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急性心肌梗死静脉溶栓病人的护理
静脉溶栓已被广泛应用于治疗急性心肌梗死,但在临床治疗过程中可能会出现一些不良反应,甚至会出现一些严重的心律失常或大出血等不良后果.因此,护理人员应与医生密切配合,提高治疗过程中的安全系数和疾病的治愈率.
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溶栓治疗视网膜中央动脉阻塞病人的护理
视网膜中央动脉阻塞是眼科临床急症之一,由于其发病迅速,预测性差,可造成视网膜急性缺血缺氧,导致视力严重下降,甚至致盲[1-3].药物治疗作用甚微,鲜有抢救成功的报道.近年来我院采用经血管内超选择眼动脉溶栓治疗该病取得一定的效果,溶栓前后的护理直接关系到病人视力的恢复.现将护理经验总结如下.
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急性心肌梗塞患者溶栓治疗前后若干血管活性物质的变化及临床意义
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股骨头缺血性坏死介入溶栓与中医结合治疗疗效分析
股骨头缺血性坏死是临床常见病,病程长,主要表现有髋关节或膝关节疼痛,活动受限、跛行.以往以内科保守治疗及晚期手术为主,介入溶栓技术的开展为其开辟了一条新的治疗途径.笔者从1999年10月开始采用此项技术,从2000年6月开始采用与中医结合治疗,取得了很好的疗效,现就我院收治的37例资料进行整理,对其方法、疗效做一回顾分析报告.
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Venous and arterial thrombosis are closely related to many severe diseases, especially to cardiovascular and cerebrovasular disorders. Thrombolytic therapy has been proven to be an effective method to treat such disease, which decreased the mortality and morbidity greatly.
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神经保护剂在溶栓治疗急性缺血性卒中的研究
尽管脑缺血神经保护治疗的基础理论研究取得了很大的进步,针对缺血性脑损害的不同机制,许多神经保护药物在动物实验获得了良好的疗效,但在人类临床试验的结果却非常令人失望.至今已有50多种神经保护剂在急性缺血性卒中的随机对照研究中进行了评估,但没有一种在Ⅲ期临床试验中显示出明确的益处.
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心血管疾病抗凝溶栓治疗的新理念
抗凝和溶栓是防治心血管疾病的重要措施.抗凝药物不但用于治疗静脉血栓和肺栓塞,还能使许多患者避免动脉血栓栓塞事件;溶栓治疗常用于快速开通血栓性阻塞的动脉血管、特别是导致急性心肌梗死的罪犯冠状动脉.近年来抗凝治疗研究很多,新药不断推出,治疗方案逐步完善.本文介绍国内外新指南中有关抗凝和溶栓药物的用法及适应证.
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急性心肌梗死的急诊溶栓治疗
急性心肌梗死(acute myocardial infarction,AMI)是威胁人类生命的常见危重急症,近年来,在治疗AMI中,溶栓治疗(thrombolytic therapy)已获得了大量成功的病例(1).已成为AMI救治的首选疗法.急诊溶栓(Emergency thrombolytic therapy,ETT)即指急诊科医生在急诊室内对急诊急性血管栓塞性疾病(如AMI、脑梗死等)的病人紧急进行静脉溶栓治疗.现就综述如下.