| Popis: |
The aim of the study was to evaluate the effectiveness of the integrated use of propranolol with heparin and percutaneous coronary intervention (PCI); propranolol with tenecteplase, syto-mask in combination with PCI and separately only PCI for hemodynamics, cardiohemodynamics and the clinical course in the acute period, as well as in the observation of MI. The results of complex drug and mechanical revascularization are compared. Materials and research methods. 63 patients with acute coronary syndrome (ACS) were examined: myocardial infarction non elevation ST segment ,at the age from 30 to 70 years (56.7 ± 1.20), which were divided into 3 groups of 21 people by randomization.In the 1st group, they were treated with heparin, propranolol with CitoMak,kardiotekct, preduktal MR35mq, BLAII and PCI; in the 2nd group, methylase (tenecteplase) and propranolol were administered, fozinopril was given, and PCI was performed after 24 hours; in the 3rd group only PCI was produced. Using echocardiography and Doppler echocardiography, the values the end systolic volume (ESV), end diastolic volume (EDV), ejection fraction (EF), stroke index (SI), cardiac index (CI), and the index of the disturbance of local left ventricular contractility (LVC) and also established the dynamics of systolic and diastolic blood pressure, the clinical course of OKMI in the observation period. Results and discussion. Administration of heparin, propranolol kardiotekst, Cito- Mak infusion, preduktal MR35 mq and AIIbl oral administration and transdermal coronary intervention (PCI) administration after 24 hours accelerate stabilization of central hemodynamics. The reduced ESV, EDV , IALC and decreased, degree improves left ventricular systolic function, increases PV. There was no restenosis, recurrence of MI and mortality. In one patient, on 5 days, was recorded DOS. During treatment with fozinopril, propranolol with heparin and PCI, central hemodynamics are systolic function (group 1). At the same time, in 2 patients, on day 3 and 3, was recorded DOS, in 1 - recurrence of MI. When only PCI was performed, 4 patients developed recurrence of MI, 4 had restenosis, 2 had AHF, and 2 died. Conclusions. The result of this work shows that the integrated use of drug therapy with percutaneous coronary intervention allows you to get a prognostically positive result in contrast to using only PCI. |
