Therapeutic Effect Of Salvianolate Combined With Recombinant Human Prourokinase On Acute ST-segment Elevation Myocardial Infarction

Objective: To observe the efficacy and safety of salvia polyphenolate combined with recombinant human urokinase in the treatment of acute ST segment elevation myocardial infarction.Methods: From January 2018 to September 2019,86 patients with acute ST-elevation myocardial infarction who were admitted to the intensive coronary heart disease ward of the Third Affiliated Hospital of Inner Mongolia Medical University were selected,including 42 males and 44 females.The patients were divided into salvia polyphenolate group and conventional thrombolytic group,and the conventional thrombolytic group was used as the control group.All patients enrolled within 30 minutes of admission were first taken of recombinant human urokinase(Shanghai Tianshili Pharmaceutical Co.,Ltd.,batch number 520110003).20 mg was dissolved in 10 ml of physiological saline,and the intravenous bolus was completed in 3 minutes.Then 30 mg of recombinant human urokinase was dissolved in 90 ml.In normal saline,intravenous drip was completed within 30 minutes.Salvia polyphenolate group: Salmon polyphenolate(Shanghai Green Valley Pharmaceutical Co.,Ltd.,batch number 17060021),200 mg(added 0.9% sodium chloride solution 250 ml),once a day for 2 weeks for thrombolytic therapy.Plasma c Tn T,CK-MB,and superoxide dismutase(SOD)activity were measured before treatment and 24 hours after treatment.All selected patients underwent echocardiography at 2 weeks to determine the left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic diameter.(LVESD),left ventricular ejection fraction(LVEF).Observe the incidence of cardiovascular adverse events within 2 weeks after treatment in the two groups: including recurrent myocardial infarction,post-infarction angina,malignant arrhythmias,cardiogenic shock,death,and bleeding.Result: There was no significant difference in CK-MB,c Tn T,and SOD between salviapolyphenolate group and conventional thrombolytic group before treatment(P> 0.05);The levels of CK-MB,c Tn T,and SOD in salvia polyphenolate group and conventional thrombolytic group after 24 hours of thrombolytic therapy were higher than those before treatment,and the difference was statistically significant(P <0.001);After 24 hours of treatment,the levels of CK-MB and c Tn T in the salvia polyphenolate group were lower than those in the conventional thrombolytic group,and the levels of SOD were higher than those in the conventional thrombolytic group.The difference was statistically significant(P <0.001).After 2 weeks of thrombolytic therapy,all patients underwent echocardiography.The left ventricular ejection fraction(LVEF)of the salvia polyphenolate group was higher than that of the conventional thrombolytic group,while the left ventricular end-diastolic diameter(LVDD)and left ventricular systole The terminal diameter(LVSD)was lower than that in the conventional thrombolytic group(P <0.05),and the difference was statistically significant.There was no significant difference in the incidence of angina pectoris,recurrent myocardial infarction,severe arrhythmia,pulmonary edema,mortality and bleeding in the salvia polyphenolate group compared with the conventional thrombolytic group(P> 0.05).Conclusion:Patients with acute ST-segment elevation myocardial infarction are prone to MIRI after intravenous thrombolysis,which affects the efficacy of reperfusion therapy.Combined application of salvia polyphenolate after thrombolysis can significantly reduce the serum CK-MB and c Tn T of patients,And increase SOD,on the other hand can reduce the LVSD and LVDD levels of patients with echocardiography,and increase LVEF.It shows that salvia polyphenolate has the effect of protecting myocardial cells and improving cardiac function,which may be related to its benefits in preventing myocardial ischemia / reperfusion injury,and has practical clinical promotion value.