冠心宁联合谷红对不稳定型心绞痛PCI术后血小板功能的影响及心肌保护作用

The effect of combined use of perhexiline and Guhong effect on unstable angina pectoris after PCI platelet function and myocardial protection

目的探讨冠心宁联合谷红对不稳定型心绞痛PCI术后血小板功能的影响及心肌保护作用。方法选取2013年12月～2014年12月收入我院的择期行PCI术的不稳定型心绞痛患者84例,随机分为治疗组和对照组,各42例。在PCI术前,对照组静脉注射冠心宁治疗,治疗组在对照组基础上加用谷红注射液,并对两组术中心绞痛及心电图变化、cTnT,CK-MB、LVEF变化、血小板聚集率进行比较。结果 PCI术中,治疗组心绞痛发作4例,占9.52%,显著低于对照组的14例（33.33%）,两组相比差异有统计学意义（χ^2=6.327,P〈0.05）。治疗组20例出现心电图ST段及T波变化,占47.62%,显著低于对照组的28例（66.67%）,两组相比差异有统计学意义（χ^2=5.338,P〈0.05）。术后6 h及术后24 h,治疗组cTnT水平显著低于对照组,差异具有统计学意义（P〈0.05）,但两组CK-MB差异无统计学意义（P〉0.05）。术前及术后7 d,两组LVEF数值差异无统计学意义（P〉0.05）,术后28 d,治疗组LVEF值显著高于对照组,两组相比差异具有统计学意义（t=7.282,P〈0.05）。治疗前,两组血小板聚集率差异无统计学意义（P〉0.05）,治疗后,两组血小板聚集率均有降低,但治疗组降低程度更显著（P〈0.05）。结论冠心宁联合谷红可促进UAP患者PCI术后血小板功能恢复正常,保护心肌,减少心肌损伤,对改善患者的临床预后具有重要作用。

Objective To investigate the effect of combined use of perhexiline and Guhong effect on unstable angina pectoris after PCI platelet function and myocardial protection. Methods 84 patients with unstable angina pectoris were randomly divided into treatment group and control group with 42 cases in each group. Before the PCI, perhexiline was used in control group, perhexiline and Guhong injection were used in the treatment group, and two groups of angina and ECG changes, cTnT, CK-MB, LVEF changes, platelet gathered rate were compared. Results 4 cases of angina pectoris occurred in the treatment group, accounting for 9.52%, was significantly lower than that of the control group 14 cases（33.33%）, with significant difference（χ^2=6.327, P〈0.05）. 20 cases of treatment group appeared ECG ST segment and T wave changes, accounting for 47.62%, significantly lower than the control group of 28 cases（66.67%）, the difference was statistically significant（χ^2=5.338, P〈0.05）. After 6 h and 24 h, the level of cTnT in the treatment group was significantly lower than that in the control group（P〈0.05）, but there was no significant difference between the two groups（P〉0.05）. Before and 7 d after operation, there was no significant difference in LVEF values between the two groups（P〉0.05）, 28 d after operation, LVEF in the treatment group were significantly higher than those in the control group（t =7.282, P〈0.05）. Before treatment, there was no significant difference between the two groups（P〉0.05）, and the platelet aggregation rate was decreased in the two groups, but the treatment group was more significant（P〈0.05）. Conclusion Perhexiline combined with Guhong injection can promote platelet function after percutaneous coronary revascularization in patients with unstable angina pectoris（UAP）, protect myocardial, reduce myocardial injury and improve prognosis.