复方丹参滴丸联合瑞舒伐他汀对急性心肌梗死经皮冠状动脉介入术后左心室重构及心肌纤维化的影响

Effect of Compound Danshen Dripping Pills combined with Rosuvastatin on left ventricular remodeling and myocardial fibrosis in patients with acute myocardial infarction after percutaneous coronary intervention

目的 探讨复方丹参滴丸联合瑞舒伐他汀对急性心肌梗死(AMI)经皮冠状动脉介入治疗(PCI)术后左心室重构(LVR)及心肌纤维化的影响。方法 选取2015年1月~2018年6月于江苏省中医药研究院行PCI的AMI患者80例,按照随机数字表法将其分为观察组与对照组,每组40例。两组术后均予以常规治疗,对照组予瑞舒伐他汀,观察组在对照组的基础上加用复方丹参滴丸。比较两组临床疗效,治疗前后中医证候积分、心脏超声指标、实验室指标及治疗期间药物不良反应。结果 观察组临床总有效率明显高于对照组(P <0.05)。治疗后,两组中医证候积分均较治疗前显著降低,且观察组低于对照组(P <0.05)。治疗后,两组左室射血分数较治疗前明显升高,且观察组高于对照组(P <0.05);治疗后,两组左室舒张末期内径、左室收缩末期内径较治疗前明显降低,且观察组低于对照组(P <0.05)。治疗后,两组血清基质金属蛋白酶-9、转化生长因子-β1及结缔组织生长因子水平均较治疗前降低,且观察组低于对照组(P <0.05)。治疗期间,两组均无明显不良反应发生。结论 AMI行PCI术后联合应用复方丹参滴丸和瑞舒伐他汀能够有效改善临床症状,并能一定程度延缓LVR及心肌纤维化进程。

Objective To investigate the effects of Compound Danshen Dripping Pills combined with Rosuvastatin on left ventricular remodeling(LVR)and myocardial fibrosis in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods Eighty patients with AMI who underwent PCI surgery in Jiangsu Province Academy of Traditional Chinese Medicine from January 2015 to June 2018 were selected and divided into observation group and control group according to the random number table method,with 40 cases in each group.Both groups were given routine treatment after operation,and control group was treated with Rosuvastatin,while observation group was treated with Compound Danshen Dripping Pills on the basis of control group.Clinical effect,traditional Chinese medical syndrome score,echocardiography index,laboratory index before and after treatment and adverse drug reactions were compared between two groups.Results Total clinical effective rate of observation group was higher than that of control group(P<0.05).After treatment,traditional Chinese medical syndrome scores of two groups were significantly lower than those before treatment,and observation group was lower than control group(P<0.05).After treatment,left ventricular ejection fraction of two groups was significantly higher than that before treatment,and observation group was higher than control group(P<0.05).After treatment,left ventricular end diastolic dimension and left ventricular end systolic diameter in two groups were significantly smaller than those before treatment,and observation group was smaller than control group(P<0.05).After treatment,levels of matrix metalloproteinases-9,transforming growth factor-茁1 and connective tissue growth factor in two groups were lower than those before treatment,and observation group was lower than control group(P<0.05).During the treatment,there was no obvious adverse reaction in both groups.Conclusion The combination of Rosuvastatin and Compound Danshen Dripping Pills can effectively improve the clinical symptoms of AMI patients after PCI,and delay the progression of LVR and myocardial fibrosis.