麝香保心丸联合尼可地尔对心肌梗死后冠脉微循环障碍患者心脏功能和血流动力学水平的影响

EFFECTS OF SHEXIANG BAOXIN PILL AND NICORDIL ON CARDIAC FUNCTION AND HEMODYNAMICS IN PATIENTS WITH CORONARY MICROCIRCULATION DISORDER AFTER MYOCARDIAL INFARCTION

目的分析麝香保心丸联合尼可地尔治疗心肌梗死冠状动脉微循环障碍对患者心脏功能和血流动力学水平的影响。方法选取我院于2016年5月—2018年2月收治的64例心肌梗死冠脉微循环障碍患者为研究对象,根据随机数字表法分为对照组(尼可地尔治疗)和观察组(麝香保心丸联合尼可地尔治疗),分析二组患者治疗后的临床疗效。结果二组治疗前心脏功能和血流动力学水平比较差异无统计学意义(P>0.05)。治疗后观察组左心室射血分数(LVEF)水平高于对照组,左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、全血黏度(高切值、低切值)、血浆比黏度、血小板黏附率水平均低于对照组(均P<0.05)。二组治疗前肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、内皮素(ET)、血管紧张素Ⅱ(AngⅡ)水平比较差异无统计学意义(P>0.05)。观察组治疗后TNF-α、IL-6、ET、AngⅡ水平均低于对照组(均P<0.05)。结论麝香保心丸联合尼可地尔治疗心肌梗死冠脉微循环障碍可能通过降低炎症因子、ET、AngⅡ水平的表达来达到改善患者心脏功能和血流动力学指标水平的目的。

Objective To analyze the effects of Shexiang Baoxin Pill combined with Nicorandil on cardiac function and hemodynamics in patients with coronary microcirculation disturbance of myocardial infarction.Methods From May 2016 to February 2018,the clinical data of sixty-four patients with coronary microcirculation disorder of myocardial infarction admitted to People′s Hospital of Langfang were selected and the patients were randomly divided into control group(treated with nicorandil)and observation group(treated with Shexiang Baoxin pill combined with Nicorandil).The clinical efficacy of the two groups after treatment was analyzed.Results There was no significant difference in cardiac function and hemodynamics between the two groups before treatment(P>0.05).After treatment,the levels of LVEF and LVESV in the observation group were higher than those in the control group.The levels of LVEDV,whole blood viscosity(high shear value,low shear value),plasma specific viscosity and platelet adhesion rate in the observation group were lower than those in the control group(P<0.05).There was no significant difference in the levels of TNF-α,IL-6,ET and AngⅡbetween the two groups before treatment(P>0.05).After treatment,the levels of TNF-α,IL-6,ET and AngⅡin the observation group were lower than those in the control group(P<0.05).Conclusion Shexiang Baoxin Pill combined with Nicorandil in the treatment of coronary microcirculation disturbance in patients with myocardial infarction may improve cardiac function and hemodynamic indexes by reducing the expression of inflammatory factors,ET and AngⅡ.