依那普利叶酸片联合麝香保心丸对行急诊PCI的STEMI病人血浆炎性指标及心脏功能的影响

The Influence of Enalapril Folic Acid Tablets Plus Shexiang Baoxin Pills on the Plasma Inflammatory Markers and Cardiac Function in Patients with STEMI Undergoing Emergency PCI

目的探讨依那普利叶酸片联合麝香保心丸对行急诊经皮冠状动脉介入术(PCI)的ST段抬高型心肌梗死(STEMI)病人炎性指标和心功能的影响。方法选取2016年1月—2017年7月入院的STEMI且行急诊PCI的病人70例,随机分为马来酸依那普利组(对照组)和马来酸依那普利叶酸片联合麝香保心丸组(试验组),各35例。分别评价两组病人住院时及治疗3个月后超敏C反应蛋白(hs-CRP)、血浆中N末端脑钠肽前体(NT-proBNP)、血浆同型半胱氨酸(Hcy)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)等指标。结果两组病人入院时基线资料相匹配(P>0.05)。治疗3个月后,试验组血浆Hcy水平明显低于入院时水平,且明显低于对照组(P<0.05)。两组血浆hs-CRP均明显降低(P<0.05),试验组明显低于对照组(P<0.05)。两组病人LVEF均较入院时明显升高,LVEDD明显降低,有统计学意义(P<0.05),两组间比较亦有统计学意义(P<0.05)。结论马来酸依那普利叶酸片联合麝香保心丸能有效降低行急诊PCI术的STEMI病人血浆Hcy、CRP水平,并可改善心功能。

Objective To investigate the effects of enalapril folic acid tablets plus Shexiang Baoxin pills（ SBP） on inflammatory markers and cardiac function in patients with ST-elevation myocardial infarction（ STEMI） undergoing emergency percutaneous coronary intervention（ PCI）.Methods Seventy patients with STEMI undergoing emergency PCI were collected from January 2016 to July 2017.All patients were randomly divided into two groups： control group（ n = 35） treated with enalapril folic acid tablets,and treatment group（ n = 35） treated with enalapril folic acid tablets plus SBP for 3 months.The concentrations of plasma high sensitive C-reactive protein（ hs-CRP）,N-terminal probrain natriuretic peptide（ NT-proBNP）,homocysteine（ Hcy）,and left ventricular ejection fraction（ LVEF）,left ventricular end-diastolic diameter（ LVEDD） were assessed on admission and 3 months after treatment.Results After 3 months of treatment,the Hcy concentration in treatment group was lower than that in control group as well as that on admission（ P〈0.05）.The hs-CRP concentration reduced significantly in two groups（ P〈0.05）,which was lower in treatment group than that in control group（ P〈0.05）.Compared with those on admission,the LVEF increased and LVEDD decreased in two groups（ P〈0.05）.In addition,there were significant differences in the LVEF and LVEDD between two groups（ P〈0.05）.Conclusion Enalapril folic acid tablets plus SBP can effectively reduce the plasma levels of Hcy,hs-CRP,and improve cardiac function in patients with STEMI undergoing emergency PCI.