通心络联合曲美他嗪在急性ST段抬高型心肌梗死经皮冠状动脉介入术后应用对心功能的影响

Clinical study on the effect of Tongxinluo combined with trimetazidine on cardiac function in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention

目的:探讨通心络联合曲美他嗪在急性ST段抬高型心肌梗死经皮冠状动脉介入术后患者中应用对心功能影响的临床效果。方法:选取我院2014年3月~2016年9月期间因ST段抬高型心肌梗死需经皮冠状动脉介入术治疗患者190例,按入院时间先后分为观察组和对照组,每组95例,对照组予以常规治疗(阿司匹林、单硝酸异山梨酯、酒石酸美托洛尔、硫酸氢氯吡格雷、卡托普利、阿托伐他汀钙和利尿剂)和曲美他嗪片,观察组在对照组基础上予以通心络治疗,比较两组治疗前后生化指标超敏C-反应蛋白(hs-CRP)、醛固酮、N端脑钠肽前体(NT-proBNP)、肿瘤坏死因子-α(TNF-α)、白细胞介素(IL)-6和心功能指标左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、左心室射血分数(LVEF)、每搏输出量(SV)。结果:治疗后两组生化指标均较本组治疗前显著降低,差异有统计学意义(P<0.05),观察组治疗后hs-CRP、醛固酮、NT-proBNP、TNF-α和IL-6均显著低于对照组治疗后,差异有统计学意义(P<0.05);治疗后两组心功能指标均较本组治疗前显著改善,其中LVEDV、LVESV显著降低,LVEF、SV显著升高,差异有统计学意义(P<0.05),观察组治疗后LVEDV、LVESV显著低于对照组治疗后,观察组治疗后LVEF、SV显著高于对照组治疗后,差异均有统计学意义(P<0.05)。结论:通心络联合曲美他嗪在急性ST段抬高型心肌梗死经皮冠状动脉介入术后患者中应用临床效果较好,可稳定斑块,有效改善微循环和心功能,推荐临床广泛应用。

Objective：To investigate the clinical effect of Tongxinluo combined with trimetazidine on cardiac function in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention.Methods：From March 2014 to September 2016,190 patients with ST-segment elevation myocardial infarction with percutaneous coronary intervention were selected.According to the admission time,the patients were divided into observation group and control group.The control group was treated with conventional therapy（aspirin,isosorbide dinitrate,metoprolol tartrate,clopidogrel sulfate,captopril,atorvastatin calcium and diuretics）and trimetazidine,and the observation group based on the control group was given Tongxinluo combined treatment.Each group of 95 cases,hs-CRP,aldosterone,NT-proBNP,TNF-α,IL-6,and cardiac function（LVEDV、LVESV、LVEF、SV）were compared.Results：After treatment,the biochemical indexes of the two groups were significantly lower than those before the treatment（P〈0.05）.The Hs-CRP,aldosterone,NT-proBNP,TNF-αand IL-6in the observation group were significantly lower than those in the control group（P〈0.05）;The cardiac function indexes of the two groups were significantly improved after treatment.LVVEV and LVESV in the observation group were significantly lower than in the control group;LVEF and SV were significantly higher than those in the control group（P〈0.05）.Conclusions：Tongxinluo combined with trimetazidine in patients with acute ST-segment elevation myocardial infarction after percutaneous coronary intervention in patients with clinical effect is better,can stablize plaque,and effectively improve microcirculation and cardiac function.A wide range of clinical application is recommended.