丹参酮ⅡA磺酸钠对急性心肌梗死缺血再灌注心肌功能及预后的影响

The effects of tanshinone ⅡA on myocardial function and prognosis of patients with acute myocardial infarction after ischemia-reperfusion

目的观察丹参酮ⅡA磺酸钠对急性心肌梗死缺血再灌注心肌功能及预后的影响。方法选取306例急性心肌梗死患者入院后48h内行经皮冠状动脉介入(PCI)治疗,分为常规对照组、阳性对照组以及观察组,比较3组研究对象TIMI血流分级、炎症因子及氧化应激因子水平以及1年内临床心脏主要不良事件发生率。结果3组患者PCI术后TIMI血流分级比较,差异有统计学意义(P<0.05),观察组及阳性对照组较常规对照组TIMI血流分级较高,观察组与阳性对照组TIMI血流分级比较差异无统计学意义(t=0.91,P=0.26)。PCI术后24h3组研究对象TNF-α、IL-6、MDA、SOD及NO水平差异均无统计学意义(P>0.05),PCI术后7d3组研究对象TNF-α、IL-6、MDA、SOD及NO水平差异均有统计学意义(P<0.05),阳性对照组及观察组较常规对照组TNF-α、IL-6、MDA、SOD、NO水平低,观察组与阳性对照组比较,炎症因子及氧化应激因子水平比较差异无统计学意义(t=0.84,P=0.32)。3组研究对象1年内的临床心脏主要不良事件(MACE)发生率分别为53.92%、20.59%以及20.59%,阳性对照组与观察组较常规对照组MACE发生率低,差异有统计学意义(P<0.05);阳性对照组与观察组相比差异无统计学意义(t=0.74,P=0.37)。结论丹参酮ⅡA磺酸钠注射液具有保护冠状动脉血流灌注、降低急性心肌梗死缺血再灌注后炎症因子及氧化应激因子水平以及临床心脏主要不良事件(MACE)的发生率的作用。

Objective To observe the effects of tanshinoneⅡA on myocardial function and prognosis of patients with acute myocardial infarction(AMI)after ischemia-reperfusion.Methods A total of 306 patients with AMI who underwent percutaneous coronary intervention(PCI)in 24h after admission were divided into routine treatment group,positive control group and observation group.The TIMI grading,the levels of inflammatory factor and oxidative stress factors as well as the incidence rate of the main adverse cardiac events(MACE)in a year were observed and compared among the three groups.Results There was significant difference in the TIMI grading after percutaneous coronary intervention(PCI)among the three groups(P<0.05),and the TIMI grading in positive control group and observation group was higher than that in routine treatment group,however,there was no significant difference between positive control group and observation group(P>0.05).There were no significant differences in the levels of TNF-α,IL-6,MDA,SOD and NO at 24h after PCI among the three groups(P>0.05),however,there were significant differences in the levels of TNF-α,IL-6,MDA,SOD and NO at 7d after PCI among the three groups(P<0.05).The levels of TNF-α,IL-6,MDA,SOD and NO in positive control group and observation group were lower than those in routine treatment group,and there were no significant differences in the levels of inflammatory factors and oxidative stress factors between positive control group and observation group(P>0.05).The incidence rates of the MACE in one year in the three groups were 53.92%,20.59%and 20.59%,respectively,which in positive control group and observation group were significantly lower than those in routine treatment group(P<0.05),however,there were no significant differences between positive control group and observation group(P>0.05).Conclusion The tanshinoneⅡA has the effects in protecting the coronary micro-circulation perfusion,reducing the levels of inflammatory factor and oxidative stress factors,decreasing the incidence rate of MACE of patients with AMI after ischemia-reperfusion.