急性心肌梗死急诊冠状动脉介入后应用丹参多酚酸盐联合生脉注射液治疗的临床疗效观察

Clinical Observation of Salvianolate Combined with Shengmai Injection in the Treatment of Acute Myocardial Infarction after PCI

目的探讨丹参多酚酸盐联合生脉注射液应用于急性心肌梗死(AMI)急诊冠状动脉介入术(PCI)后应用的临床疗效。方法选择2016年1月—2017年9月我院收治的行急诊冠状动脉介入术治疗的80例急性心肌梗死病人,分为研究组和对照组各40例。两组病人于PCI术前均口服氯吡格雷和阿司匹林。对照组在PCI术后给予常规西药治疗;研究组在对照组基础上联合丹参多酚酸盐(150mg,每日1次)和生脉注射液(50mL,每日1次)。观察治疗前、治疗24h、治疗48h、治疗72h和治疗7d时两组血清N末端脑利钠肽前体(NT-proBNP)、心肌肌钙蛋白I(cTnI)、高敏C反应蛋白(hs-CRP)血清学指标以及左室射血分数(LVEF)、左心室舒张末期内径(LVED)、左心室舒张末期容量(LVEDV),并统计不良反应发生率及并发症情况。结果经过治疗后两组血清NT-proBNP、cTnI、hs-CRP、LVED和LVEDV水平均呈下降趋势,LVEF呈上升趋势;研究组自治疗24h起血清NT-proBNP水平较对照组明显下降,且随治疗时间呈正相关性(P<0.05);研究组血清hs-CRP水平在治疗48h后与对照组比较开始呈显著下降(P<0.05),研究组治疗72h时血清cTnI水平显著低于对照组(P<0.05),但治疗7d时两组间比较差异无统计学意义;治疗后研究组LVEF显著高于对照组(P<0.05);研究组自治疗24h起LVEDV显著低于对照组,而治疗72h和治疗7d时LVED显著低于对照组(P<0.05)。经过治疗后,研究组和对照组QRS积分和梗死面积均显著减小,研究组并发症总发生率显著低于对照组(12.50%与35.00%,P<0.05)。对照组和研究组发生慢血流现象及不良反应发生率对比差异无统计学意义(P>0.05)。结论急性心肌梗死急诊PCI术后联合使用丹参多酚酸盐与生脉注射液能够有效减弱病人心肌损伤程度,从而改善心功能。

Objective To investigate the effect observation of Salvianolate combined with Shengmai injection on the of acute myocardial infarction after percutaneous coronary intervention(PCI).Methods Eighty patients withacute myocardial infarction treated by emergency coronary intervention were randomly divided into the study group and the control group,40 cases in each group.The control group was given conventional treatment,and the study group was treated with Salvianolate on the basis of the control group.The levels of N-terminal pro brain natriuretic peptide(NT-proBNP),cardiac troponin I(cTnI),hypersensitive C-reactive protein(hs-CRP),left ventricular ejection fraction(LVEF),left ventricular diastolic diameter(LVED),and left ventricular end diastolic volume(LVEDV)were compared between the two groups.The incidence of adverse reactions and complications were record.Results The levels of NT-proBNP,cTnI,hs-CRP,LVED,and LVEDV of the two groups were decreased,and LVEF was increased.The levels of NT-proBNP,cTnI,and hs-CRP in the study group were significantly decreased than those in the control group.LVEF was significantly increased than that in the control group(P<0.05)after 48 h.LVED in the study group was significantly decreased than that in the control group(P<0.05)after 72 h and 7 d.LVEDV in the study group was significantly decreased than that in the control group(P<0.05)after 24 h.After treatment,the QRS score and infarction area of the two groups were significantly decreased(P<0.05).The total incidence of complications in the study group was significantly decreased than that in the control group(12.50%vs 35.00%,P<0.05).Conclusion Salvianolate combined with Shengmai injection in the treatment of acute myocardial infarction after PCI could effectively reduce myocardial damage and improve cardiac function.