速效救心丸干预对稳定型心绞痛介入治疗患者围术期心肌保护作用的研究

Protective Effects of Suxiao Jiuxin Pill on Myocardium in Stable Angina Pectoris after PCI

目的探讨速效救心丸对稳定型心绞痛患者(SA)经皮冠状动脉介入术(PCI)效果的影响,观察其围术期的心肌保护作用。方法 60例行冠状动脉造影检查并行PCI术的气滞血瘀型稳定型心绞痛患者,随机分为速效救心丸治疗组30例(治疗组)和单用西药对照组30例(对照组),观察速效救心丸干预对稳定型心绞痛患者支架植入术前后血液心肌酶、冠脉血流以及围术期心肌梗死发生率的影响。结果 PCI术前心肌梗死溶栓(TIMI)血流分级达到3级者,治疗组26例,对照组20例,两组比较差异无统计学意义(P>0.05);术后TIMI血流3级者,治疗组30例,对照组26例,两组比较差异无统计学意义(P>0.05),治疗组PCI术后冠脉血流改善有优于对照组的趋势。两组均可以降低稳定型心绞痛患者择期PCI术围术期心肌酶水平,两组术后24h血肌钙蛋白(TnI)浓度差异有统计学意义(P<0.05);治疗组围术期心肌损伤与心肌梗死的发生率明显低于对照组(P<0.05)。结论与单纯西药治疗相比,速效救心丸治疗有改善稳定型心绞痛患者支架植入后的冠脉血流灌注的趋势,且可降低稳定型心绞痛患者PCI围术期血心肌酶水平,减少围术期心肌梗死的发生率。

Objective To investigate the protective effects of Suxiao Jiuxin pill（SJP） on myocardium for the patients with stable angina （SA） underwent percutaneous coronary intervention （PCI）. Methods Sixty SA patients with blood stasis syndrome due to qi stagnation,underwent coronary angiography and PCI, were randomly divided into two groups：Control group （n=30） treated with standard western medicine,treatment group （n= 30） treated with SJP and standard western medicine. To investigate the effects of SJP, myocardial enzymes,coronary blood flow, and the incidence of perioperative myocardial infarction were compared before and af ter PCI. Results Before PCI,26 cases in treatment group had 3 grades thrombolysis in myocardial infarction （TIMI） flow and 20 ca ses in control group（P〉0.05）. After PCI,30 cases in treatment group had 3 grades TIMI flow and 26 cases in control group （P=0. 056）. There was a trend of the coronary blood flow in treatment group was better than that in control group after PCI. The myocardial en- zymes were decreased in both groups. The concentration of TnI in 24 hours after PCI had significant difference （P〈0.05） between two groups. Compared with the control group, the incidence of perioperative myocardial injury and myocardial infarction were signifi cantly lower in treatment group （P%0.05）. Conclusion Compared with standard western medieine,SJP plus standard western medi cine therapy could further reduce the myocardial enzymes level,improve the coronary blood flow,decrease the incidence of periopera tive myocardial infarction in the SA patients before and after PCI.