老年急性ST段抬高型心肌梗死患者冠脉介入术后服用麝香保心丸的临床疗效及安全性观察

Observation of efficacy and safety of heart-protecting musk pills in the treatment of elderly patients with acute ST segment elevation myocardial infarction after percutaneous coronary intervention

目的:观察老年急性ST段抬高型心肌梗死患者冠脉介入术后服用麝香保心丸的临床疗效及安全性。方法:将66例择期行冠脉介入术的老年急性ST段抬高型心肌梗死患者随机分为对照组和观察组,每组各33例。两组患者均给予常规治疗,行经皮冠状动脉介入术;对照组患者术后给予阿司匹林肠溶片300 mg、硫酸氢氯吡格雷片75 mg,1次/d;观察组患者在对照组的基础上给予麝香保心丸25 mg每次口服,3次/d。两组患者均以4周为1个疗程,共治疗1个疗程。治疗结束后,比较两组患者的肌酸激酶(CK)、乳酸脱氢酶(LDH)、脑钠尿肽(BNP)、肌钙蛋白T(Tn T)和、左心室射血分数(LVEF)水平以及不良反应发生情况。结果:观察组患者持续ST段抬高>0.2 m V的比例和心绞痛、再次心肌梗死、心源性死亡及心因性死亡等心血管事件发生率显著低于对照组(P<0.05);治疗后,两组患者的血清肌酸激酶、乳酸脱氢酶、脑钠尿肽及肌钙蛋白T水平均显著低于治疗前,且观察组患者的降低幅度大于对照组(P<0.05);两组左心室射血分数水平均显著高于治疗前,且观察组水平显著高于对照组(P<0.05)。两组患者不良反应的发生率相比较,差异无统计学意义(P>0.05)。结论:在常规治疗基础上,老年急性ST段抬高型心肌梗死患者冠脉介入术后给予服用麝香保心丸有助于提高其临床疗效,且安全性好。

Objective: To evaluate efficacy and safety of heart-protecting musk pills in the treatment of elderly patients with acute ST segment elevation myocardial infarction after percutaneous coronary intervention. Methods: A total of 66 patients with acute ST segment elevation myocardial infarction undergoing the elective percutaneous coronary intervention were collected and randomly divided into control group( n = 33) and observation group( n = 33). The patients in the two groups were given the conventional therapy and underwent the percutaneous coronary intervention. After the operation,the patients in control group were given aspirin enteric coated tablets 300 mg,clopidogrel hydrogen sulfate tablets 75 mg,once a day; besides,the patients in observation group orally took heart protecting musk pills 25 mg,3 times a day. The two groups were treated for4 weeks for a course of treatment,and a total of 1 course of treatment was used. After the treatment,the levels of creatine kinase( CK),lactate dehydrogenase( LDH),brain natriuretic peptide( BNP),cardiac troponin T( Tn T),left ventricular ejection fraction( LVEF) and adverse reactions of the two groups were compared.Results: The proportion of the patients with persistent ST segment elevation > 0.2 m V and the incidence rates of angina pectoris,myocardial infarction again,cardiac death and psychogenic death and other cardiovascular events of observation group were significant lower than those of control group( P<0.05). After the treatment,the serum CK,LDH,BNP and Tn T levels of the two groups were significant lower than those before the treatment,and the reductions of observation group were significant greater than those of control group( P<0.05). The left ventricular ejection fraction levels of the two groups after the treatment were significant higher than those before the treatment,and the levels of observation group were significantly higher than those of control group( P<0.05). There were no significant differences of the incidence rates of adverse reactions between the two groups( P > 0. 05). Conclusions: Heart-protecting musk pills based on the conventional therapy in the treatment of the elderly patients with acute ST segment elevation myocardial infarction after percutaneous coronary intervention can improve the clinical efficacy significantly and is safe.