急性心肌梗死患者行经皮冠状动脉介入治疗后应用乌司他丁改善再灌DOI：10.16662/jki.1674-0742.2017.11.083[摘要]目的探?分析急性心肌梗死患者行经皮冠状动脉介入治疗后应用乌司他丁改善再灌注性心律失常的临床效果。方法随机选取2015年1月―2017年1月该院收治的急性心肌梗死患者100例，随机分为观察组与对照组，各50例，对照组患者在12h内行经皮冠状动脉介入治疗术以开通冠状动脉，观察组在对照组基础上增加乌司他丁治疗，比较两组间心律失常发生率，术前1h、术后2、24、48、72h的IL-10、IL-6水平、QTd、QTcd及SOD情况。结果观察组在IL-10与SOD水平方面显著高于对照组（P<0.05），72h后对照组IL-10为（9.79±1.07）pg/mL，SOD为（42.17±6.93）pg/mL，观察组IL-10为（15.01±1.23）pg/mL，SOD为（47.19±11.65）pg/mL。心律失常发生率（对照组56%，观察组40%）、IL-6水平为、QTd及QTcd方面显著低于对照组（P<0.05），72h后对照组IL-6为（4.49±0.35）pg/mL，QTd为（54.52±9.05）ms，QTcd为（73.44±6.65）ms，观察组IL-6为（3.21±0.33）pg/mL，QTd为（47.62±11.58）ms，QTcd为（51.36±7.69）ms。结论急性心肌梗死患者行经皮冠状动脉介入治疗后应用乌司他丁可以有效降低恶性心律失常，值得进一步研究推广。[关键词]急性心肌梗死；乌司他丁；心律失常；经皮冠状动脉介入治疗[]R54[文献标识码]A[]1674-0742（2017）04（b）-0083-03EvaluationofClinicalEffectofUlinastatininImprovingtheReperfusionArrhythmiasafterthePercutaneousCoronaryInterventionalTreatmentforPatientswithAcuteMyocardialInfarctionZHENGLei-leiDepartmentofCardiology，DongyingHonggangHospital，Dongying，ShandongProvince，257000China[Abstract]ObjectiveTostudytheclinicaleffectofUlinastatininimprovingthereperfusionarrhythmiasafterthepercutaneouscoronaryinterventionaltreatmentforpatientswithacutemyocardialinfarction.MethodsRandomselection100casesofpatientswithacutemyocardialinfarctionadmittedandtreatedinourhospitalfromJanuary2015toJanuary2017wereselectedandrandomlydividedintotwogroupswith50casesineach，thecontrolgroupadoptedthepercutaneouscoronaryinterventionaltreatmentin12handopenedthecoronaryanomaly，whiletheobservationgroupaddedtheulinastatintreatmentonthebasisofthecontrolgroup，andtheincidencerateofarrhythmia，IL-10andIL-6levelsin1hbeforeoperationand2，24，48hand72hafteroperation，QTd，QTcdandSODwerecomparedbetweenthetwogroups.ResultsTheIL-10andSODlevelsintheobservationgroupwereobviouslyhigherthanthoseinthecontrolgroup（P<0.05），andtheIL-10，SODafter72hinthecontrolgroupandintheobservationgroupwererespectively[（9.79±1.07），（42.17±6.93）pg/mLvs（15.01±1.23），（47.19±11.65）pg/mL]，andtheincidencerateofarrhythmiainthecontrolgroupandintheobservationgroupwasrespectively56%and40%，andtheIL-6level，QTdandQTcdintheobservationgroupwereobviouslylowerthanthoseinthecontrolgroup，P<0.05，after72h，theIL-6，QTdandQTcdafter72hinthecontrolgroupandintheobservationgroupwererespectively[（4.49±0.35）pg/mL，（54.52±9.05）msand（73.44±6.65）msvs（3.21±0.33）pg/mL，（47.62±11.58）msand（51.36±7.69）ms].ConclusionTheapplicationofulinastatinforpatientswithacutemyocardialinfarctionafterthepercutaneouscoronaryinterventionaltreatmentcaneffectivelyreducethemalignantarrhythmia，whichisworthfurtherresearchandpromotion.[Keywords]Acutemyocardialinfarction；Ulinastatin；Arrhythmia；Percutaneouscoronaryinterventionaltreatment急性心肌梗死（AMI）是由于冠状动脉粥样硬化斑块破裂，造成冠动脉供血中断或急剧减少或血栓性阻塞，使心肌持久严重的缺血，引起心肌坏死[1]。经皮冠状动脉介入治疗（PCI）是目前治疗AMI最重要的手段之一，其血管开通率大于95%[...