Sidorenko G I, Gelis L G, Medvedeva E A, Ostrovskiĭ Iu P, Lazareva I V, Sevruk T V, Shibeko N A, Petrov Iu P
Ter Arkh. 2011;83(9):35-40.
To assess efficacy of reamberin in preoperative preparation and after coronary bypass (CB) in patients with macrofocal myocardial infarction (MI) complicated with postinfarction angina.
A total of 45 patients with Q-positive MI complicated with postinfarction angina pectoris entered the trial. The study group consisted of 20 (44.4%) patients given 200-400 ml injections of 1.5% reamberin solution for 3 days before coronary artery bypass grafting (CABG) and 3-5 days after it. The control group consisted of 25 (55.6%) patients given basic therapy without cardioprotection. ECTG-60, echocardiography, CM-ECG, laboratory tests were made before CABG. CABG was made in conditions of artificial blood circulation in all the patients.
Clinical stabilization was observed after direct myocardial revascularization in hospitalized 25 (100%) patients of the study group and 22 (88%) patients of the control group. Early postoperative acute cardiac failure (ACF) developed in 3 (12%) patients from the study group and 9 (36%) from the control group (p = 0.04), arrhythmia occurred in 2(8%) and 8(32%) patients, respectively (p = 0.03). Two (8%) control patients died in early postoperative period from acute cardiac failure. Perioperative MI occurred in 2(8%) control patients. After 12 months of the follow-up, patients of the study group had no recurrent angina pectoris, while among the controls 4(16%) patients had recurrent angina of FC III. After surgical intervention at discharge and 12 months after treatment patients of both groups improved systolic and diastolic functions of the left ventricle. Normalization of the diastolic function was registered in 80% patients of the study group (p < 0.001) and in 44% from the control group (p < 0.001) after 1 year follow-up.
Reamberin reduces the number of postoperative complications, ischemic damage to the myocardium, significantly improves systolic and diastolic functions of the left ventricle.
评估瑞潘通在术前准备及冠状动脉搭桥术（CB）后对大面积心肌梗死（MI）合并梗死后心绞痛患者的疗效。
共有45例Q波阳性心肌梗死合并梗死后心绞痛患者进入试验。研究组由20例（44.4%）患者组成，在冠状动脉旁路移植术（CABG）前3天及术后3 - 5天给予200 - 400毫升1.5%瑞潘通溶液注射。对照组由25例（55.6%）患者组成，给予无心脏保护作用的基础治疗。在CABG前进行心电图运动试验（ECTG - 60）、超声心动图、动态心电图（CM - ECG）及实验室检查。所有患者均在人工血液循环条件下进行CABG。
研究组25例（100%）住院患者和对照组22例（88%）患者在直接心肌血运重建后观察到临床稳定。研究组3例（12%）患者和对照组9例（36%）患者术后早期发生急性心力衰竭（ACF）（p = 0.04），心律失常分别发生在2例（8%）和8例（32%）患者中（p = 0.03）。2例（8%）对照组患者术后早期死于急性心力衰竭。2例（8%）对照组患者发生围手术期心肌梗死。随访12个月后，研究组患者无心绞痛复发，而对照组中有4例（16%）患者出现Ⅲ级劳力性心绞痛复发。手术干预出院时及治疗12个月后，两组患者左心室收缩和舒张功能均有改善。随访1年后，研究组80%患者舒张功能恢复正常（p < 0.001），对照组44%患者舒张功能恢复正常（p < 0.001）。
瑞潘通可减少术后并发症数量、心肌缺血损伤，显著改善左心室收缩和舒张功能。
