欣维宁对急性冠脉综合征患者冠状动脉介入治疗后的影响

Effect of Xinweining on Patients with Acute Coronary Syndrome Following Percutaneous Coronary Intervention

目的:探讨替罗非班(欣维宁)对急性冠脉综合征(ACS)患者冠状动脉介入治疗(PCI)术后的影响。方法:选取入住安贞医院心内科,经冠状动脉造影确诊为ACS,并接受PCI术的患者共106例,随机分为欣维宁组和对照组,欣维宁组于PCI术后除常规外立即给予欣维宁4mL/h泵入,持续24h。对照组PCI术后常规。观察两组心绞痛发作次数,两组术前、术后即刻、24h、48h、72h血压、心率、心肌耗氧指数变化以及C反应蛋白(CRP)和氨基末端脑钠肽前体(NT-proBNP)水平。结果:两组在术前和术后即刻血压、心率并无显著差别,但术后24h欣维宁组较对照组血压、心率均有明显降低,欣维宁组:血压(122.8±16.7)mmHg/(72.5±6.7)mmHg,心率(67.4±8.5)次/分;对照组:血压(135.6±18.9)/mmHg(86.2±9.7)mmHg,心率(78.9±10.6)次/min,两组比较差别有统计学意义(P<0.01),且一直保持到术后72h,欣维宁组可有效降低心肌耗氧指数。两组在术前和术后即刻CRP、NT-proBNP并无显著差别,但术后较术前CRP、NT-proBNP水平升高,欣维宁组:术前CRP(20.4±4.3)mg/L,NT—proBNP(254.2±31.7)ng/L,术后即刻CRP(39.8±8.6)mg/L,NT-proBNP(448.9±51.2)ng/L;对照组:术前CRP(18.6±5.2)mg/L,NT-proBNP(210.5±29.8)ng/L,术后即刻CRP(41.2±9.1)mg/L,NT-proBNP(502.6±57.4)ng/L。术后24h欣维宁组较对照组CRP、NT-proBNP均有明显降低,欣维宁组:CRP(25.2±3.2)mg/L,NT-proBNP(202.5±21.4)ng/L;对照组:CRP(39.7±8.5)mg/L,NT-proBNP(482.3±49.7)ng/L,两组比较差别有统计学意义(P<0.05),且一直保持到术后72h。结论:欣维宁可降低ACS患者PCI术后的心率、血压、心肌耗氧指数,并可显著降低PCI术后CRP和NT-proBNP水平,有可能改善ACS患者PCI的预后。

Objective:To observe effects of Xinweining on patients with acute coronary syndrome following percutaneous coronary intervention.Methods: a total of 106 patients with acute coronary syndromes and underwent percutanous coronary intervention were enrolled in this report. They were randomized into the xinweining in which Xinweining was administered, 4ml/h for 24 hours, by intravenous infusion following PCI and control group. Angina pectoris, blood pressure and heart rates were recorded; all patients underwent ...