心脉隆注射液对急性心肌梗死介入术后心力衰竭患者的疗效观察

Effectiveness of Xinmailong Injection in Treating Heart Failure after Percutaneous Coronary Intervention for Patients with Acute Myocardial Infarction

目的观察心脉隆注射液对急性心肌梗死急诊介入术后心力衰竭患者心功能恢复情况和预后的影响。方法将30例急性心肌梗死接受急诊介入治疗后出现心力衰竭的患者随机分为常规治疗组和心脉隆组,常规治疗组给予阿司匹林、氯吡格雷、利尿剂、β-受体阻滞剂等常规治疗,心脉隆组在常规治疗基础上加用心脉隆注射液6 ml静脉滴注,治疗14 d。观察两组患者治疗前及治疗后14 d血浆肌钙蛋白I、超敏C-反应蛋白和N末端脑钠肽(NT-proBNP)水平的变化,观察两组患者术后6 h及治疗1个月后室壁运动积分、左室射血分数(LVEF)和治疗后1个月的6 min步行距离的变化。结果两组治疗前血浆肌钙蛋白I、超敏C-反应蛋白、NT-proBNP水平比较,差异均无统计学意义(P>0.05)。治疗后14 d心脉隆组血浆肌钙蛋白I、超敏C-反应蛋白、NT-proBNP水平均明显低于常规治疗组,差异有统计学意义(P<0.01)。治疗1个月后心脉隆组室壁运动积分、LVEF和6 min步行距离均明显优于常规治疗组,差异有统计学意义(P<0.05)。结论心脉隆注射液可以改善心肌灌注,减轻神经内分泌激活,减少梗死范围,改善心功能。

Objective To explore the effectiveness of Xinmailong Injection in treating heart failure after percutaneous coronary intervention （PCI） for patients with acute myocardial infarction （AMI）. Methods A total of 30 patients who developed heart failure after PCI for AMI were randomized into two groups ： control group （provided with routine treatment including aspirin, clopidogrel, diuretics, and beta blockers） and Xinmailong group （provided with routine treatment plus Xinmailong Injection 6 ml iv, for 14 days）. The changes of the plasma levels of cardiac troponin I （cTnI）, high -sensitivity C -reactive protein （hs- CRP）, and N -terminal brain natriuretic peptide （NT -proBNP） before and 14 days after treatment were determined. The left ventricular ejection fraction （LVEF） and wall motion score index （WMSI） 6 h and 1 month after treatment and 6 - minute walk distance 1 month after treatment were measured. Results The cTnI, hs - CRP, and NT - proBNP, were not signifi- cantly different before admission between two groups （P 〉 0. 05）. After 14 days, the cTnI, hs - CRP and NT - proBNP in Xinmailong group was significantly lower than in the control group （P 〈 0. 01 ）. In addition, the LVEF, WMSI, and 6 - minute walk distance in Xinmailong group were significantly better than in the control group 1 month after treatment （ P 〈 0. 05 ）. Con- clusion Xinmailong injection can improve myocardial perfusion, slow down the neuroendocrine activation, reduce myocardial infarction area, and improve the cardiac function.