灯盏花素注射液对急性心肌梗死PCI术后心肌功能的影响

Effect of Breviscapine injection on myocardial function in patients with acute myocardial infarction after PCI

目的探讨急性心肌梗死患者经皮冠状动脉介入术(PCI)后应用灯盏花素注射液治疗对患者心肌功能的影响。方法选取2017年3月至2018年9月行PCI术治疗的急性心肌梗死患者82例为研究对象,随机分为研究组与对照组,各41例。对照组患者在术后进行常规治疗,研究组患者在对照组的基础上给予灯盏花素注射液治疗,对比两组治疗前和治疗14 d后血清氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]、血清炎症指标[肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、白介素-6(IL-6)]、心肌功能指标[血清肌钙蛋白T(cTnT)、N末端B型利钠肽前体(NT-proBNP)、肌酸激酶同工酶MB(CK-MB)和超声心动图左心室射血分数(LVEF)]的变化,并观察两组患者术后不良心血管事件的发生情况。结果治疗14 d后,两组SOD水平高于治疗前,MDA低于治疗前,且研究组患者治疗后SOD水平高于对照组,MAD水平低于对照组,差异有统计学意义(P<0.05)。治疗14 d后,两组患者TNF-α、CRP、IL-6水平均高于治疗前,但研究组患者TNF-α、CRP、IL-6水平低于对照组,差异有统计学意义(P<0.05)。治疗14 d后,两组cTnT、LVEF高于治疗前,NT-proBNP、CK-MB水平低于治疗前,且研究组cTnT、LVEF高于对照组,NT-proBNP、CK-MB水平低于对照组,差异有统计学意义(P<0.05)。随访3个月,研究组患者的不良心血管事件总发生率稍低于对照组,但差异无统计学意义(4.88% vs 17.07%,P>0.05)。结论急性心肌梗死患者PCI术后在常规治疗的基础上联用灯盏花素注射液治疗可有效减轻氧化应激反应及炎症反应,改善患者心肌功能。

Objective To investigate the effect of Breviscapine injection on myocardial function in patients with acute myocardial infarction ( AMI) after percutaneous coronary intervention ( PCI). Methods A total of 82 AMI patients treated by PCI from March 2017 to September 2018 were randomly divided into study group and control group ( n =41 ,each). The routine treatment after operation was performed in control group, and Breviscapine injection was given in study group on the basis of routine treatment. The changes of the following indexes were compared between the two groups before and after treatment:seurm oxidative stress indexes [ superoxide dismutase ( SOD), Malondialdehyde( MDA)], inflammation indexes [serum tumor necrosis factor ( TNF)-α, C-reactive protein ( CRP) and interleukin-6 (IL-6 )] and myocardial function indexes [ seurm cardiac troponin T ( cTnT), N terminal pro brain natriuretic peptide ( NT-proBNP) and creatine kinase isoenzyme-MB ( CK-MB), left ventricular ejection fraction ( LVEF) by echocardiography ]. Adverse vascular events were observed after PCI in both groups. Results After 14-d treatment, SOD level increased, and MDA level decreased compared with those before treatment in both groups (P <0. 05),and SOD increased,and MDA decreased significantly in study group compared with those in control group (P <0. 05);the levels of TNF-α,CRP and IL-6 were significantly higher than those before treatment in two groups (P <0. 05),however,they were statistically lower in study group than those in control group (P <0. 05). After 14-d treatment, the levels of cTnT and LVEF increased, and the levels of NT-proBNP and CK-MB decreased in two groups,and the levels of cTnT and LVEF in study group were higher than those in control group, while the levels of NT-proBNP and CK-MB were lower than those in control group ( P < 0. 05 ). After a follow-up of 3 months, the incidence of adverse cardiovascular events in study group was slightly lower than that in control group, but there was no statistical difference (4. 88% vs 17. 07%,P >0. 05 ). Conclusion The combination of Breviscapine injection and routine treatment after PCI can effectively reduce oxidative stress and inflammation, and improve myocardial function in patients with acute myocardial infarction.