稳心颗粒联合前列地尔对急性ST段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗后室性心律失常的影响

Impact of Wenxin Grannle Combined with Alprostadil on Ventricular Arrhythmia in ASTEMI Patients Undergoing Emergency PCI

目的探讨稳心颗粒联合前列地尔对急性ST段抬高型心肌梗死患者急诊经皮冠状动脉介入治疗(PCI)后室性心律失常的影响。方法选取2017年2—10月在聊城市第二人民医院心内科行急诊PCI的急性ST段抬高型心肌梗死患者120例,采用随机数字表法分为对照组、稳心颗粒组、前列地尔组、联合组,每组30例。4组患者均给予常规药物治疗并行急诊PCI,稳心颗粒组患者术后即刻予以稳心颗粒治疗,前列地尔组患者于PCI前30 min予以前列地尔治疗,联合组患者给予稳心颗粒联合前列地尔治疗(用法用量分别同稳心颗粒组、前列地尔组)。比较4组患者术后3 d室性心律失常发生情况,术前及术后6、24、48、72 h QT间期离散度及校正的QT间期离散度(QTCD)。结果联合组患者术后3 d室性期前收缩、非持续性室性心动过速+心室颤动发生率低于对照组、稳心颗粒组、前列地尔组(P<0.05)。4组患者术前QT间期离散度、QTCD比较,差异无统计学意义(P>0.05);联合组患者术后6、24、48、72 h QT间期离散度、QTCD低于对照组、稳心颗粒组、前列地尔组(P<0.05)。结论稳心颗粒联合前列地尔可有效减少急性ST段抬高型心肌梗死患者急诊PCI后室性心律失常的发生,降低QT间期离散度及QTCD。

Objective To investigate the impact of Wenxin grannle combined with alprostadil on ventricular arrhythmia in ASTEMI patients undergoing emergency PCI.Methods From February to October 2017,a total of 120 ASTEMI patients undergoing emergency PCI were selected in the Department of Cardiology,the Second People's Hospital of Liaocheng,and they were divided into A group,B group,C group and D group according to random number table,each of 30 cases.Patients in the four groups received conventional medical treatment and emergency PCI,meanwhile patients in B group received Wenxin grannle immediately after PCI,patients in C group received alprostadil 30 minutes before PCI,patients in D group received alprostadil 30 minutes before PCI and Wenxin grannle immediately after PCI.Incidence of ventricular arrhythmia 3 days after PCI,QTd and QTCD before PCI,6 hours,24 hours,48 hours and 72 hours after PCI were compared in the four groups.Results Incidence of ventricular premature contraction,nonsustained ventricular tachycardia and ventricular fibrillation in D group was statistically significantly lower than that in A group,B group and C group,respectively(P<0.05).No statistically significant differences of QTd or QTCD was found in the four group before PCI(P>0.05),while QTd and QTCD in D group were statistically significantly lower than those in A group,B group and C group(P<0.05).Conclusion Wenxin grannle combined with alprostadil can effectively reduce the incidence of ventricular arrhythmia,QTd and QTCD in ASTEMI patients undergoing emergency PCI.