丹红注射液对PCI术后AMI病人冠状动脉血流、左心室功能及心肌功能的影响

Influences of Danhong Injection on the Coronary Blood Flow,Left Ventricular Function and Myocardial Function in Patients with AMI after PCI

目的探讨丹红注射液对经皮冠状动脉介入(PCI)术后急性心肌梗死(AMI)病人冠状动脉血流、左心室功能的影响。方法回顾性分析2013年2月—2015年3月郑州市第六人民医院住院的急诊PCI治疗的76例AMI病人临床资料,按照治疗方法分为对照组和治疗组,各38例。对照组采用常规西药药物治疗,治疗组在对照组基础上给予丹红注射液,治疗10 d后,观察比较两组临床疗效和治疗前后血脂、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)水平;采用心肌梗死溶栓治疗临床试验(TIMI)评价冠状动脉血流;采用舒张末期容积指数(LVEDVI)、收缩末期容积指数(LVESVI)、左室射血分数(LVEF)、左室质量指数(LVMI)、梗死区的局部室壁运动指数(RWMI)评价左心室功能。结果治疗组总有效率97.37%明显高于对照组89.47%(χ2=7.373,P=0.025)。治疗后,两组总胆固醇、三酰甘油、低密度脂蛋白胆固醇均较治疗前下降(P <0.05),高密度脂蛋白胆固醇水平较治疗前升高(P <0.05);治疗组较对照组改善更显著(P <0.05)。两组治疗后TIMI血流分级均较治疗前显著改善(P <0.05),两组治疗后TIMI血流分级比较差异有统计学意义(P <0.05)。治疗后,两组LVEDVI、LVESVI、LVMI、RWMI、LVEF较治疗前改善(P <0.05),且治疗组治疗后LVEDVI、LVESVI、LVMI、RWMI较对照组缩小(P <0.05),LVEF较对照组升高,两组比较差异有统计学意义(P <0.05)。两组治疗后CK、CK-MB、cTnI较治疗前均下降(P <0.05),且治疗组低于对照组(P <0.05)。结论常规治疗基础上应用丹红注射液能改善PCI术后AMI病人冠状动脉血流、左心室功能,保护心肌。

Objective To explore the influences of Danhong injection（DHI）on the coronary blood flow,left ventricular function and myocardial function in patients with acute myocardial infarctio（AMI）after percutaneous coronary intervention （PCI）.MethodsSeventysix patients with AMI undergoing emergency PCI in our hospital from February 2013 to March 2015 were randomly divided into two groups：control group （n=38）treated with routine treatment,and treatment group（n=38）treated with DHI in the basis of routine treatment for 10 days.The clinical efficacy,and blood lipid,creatine kinase（CK）,creatine kinase isoenzyme（CKMB）,and myocardial troponin （cTnI）before and after treatment were were observed.The coronary artery blood flow was evaluated by Thrombolysis in Myocardial Infarction（TIMI）.The left ventricular function was evaluated by left ventricular enddiastolic volume index（LVEDVI）,left ventricular end systolic volume index（LVESVI）,left ventricular ejection fraction（LVEF）,and left ventricular mass index（LVMI）,infarction area regional wall motion index （RWMI）.ResultsThe total clinical effective rate was significantly higher in treatment group than that in control group（97.37% vs 89.47%,P〈0.05）.After treatment,the levels of TC,TG,and LDLC were decreased in two groups,which were lower in treatment group than those in control group（P〈0.05）.The level of HDLC was increased in two groups,which was higher in treatment group than that in control group （P〈0.05）.TIMI flow grade significantly improved in two groups after treatment（P〈0.05）,and there was difference between two groups（P〈0.05）.LVEDVI,LVESVI,LVMI,RWMI,and LVEF were improved in two groups after treatment （P〈0.05）.The LVEDVI,LVESVI,LVMI,and RWMI in the treatment group were lower than those in the control group,and LVEF was higher in the treatment group than that in the control group（P〈0.05）.The levels of CK,CKMB,and cTnI were decreased after treatment（P〈0.05）,which were lower in treatment group than those in control group（P〈0.05）.ConclusionDHI can improve the coronary blood flow,promotes the left ventricular function recovery,and protect the myocardial in patients with AMI after PCI.