复方丹参滴丸对PCI术后无复流者心肌微循环的影响

Effect of Compound Danshen Dropping Pills on Myocardial Microcirculation in Patients without Reflows after PCI

目的探讨复方丹参滴丸对经皮冠状动脉介入(PCI)术后无复流者心肌微循环的改善作用。方法选取收治的180例PCI术后无复流的心肌梗死性冠心病患者,随机分为观察组和对照组,各90例。对照组采取抗凝、抗血小板聚集和营养心肌等常规治疗,观察组在常规治疗的基础上于PCI术后加用复方丹参滴丸,2组均持续应用3个月。对比2组患者心肌梗死溶栓治疗(TIMI)血流分级情况;比较2组患者心功能与主要远期心血管事件的总发生率。结果与治疗前比较,治疗后2组患者TIMI血流分级0~2级比例均显著降低,3级比例显著增高(P<0.01),观察组患者TIMI血流分级0~2级患者比例显著低于对照组,3级患者比例显著高于对照组(P<0.05);观察组LVESD、LVEDD水平显著低于对照组(P<0.01),LVEF水平显著高于对照组(P<0.01);观察组患者主要远期心血管事件总发生率显著低于对照组(P<0.05)。结论复方丹参滴丸可明显改善PCI术后无复流者心肌的微循环,改善患者心功能,降低主要远期心血管事件的总发生率。

Objective To explore the effect of compound Danshen dropping pills on myocardial microcirculation in patients without reflow after percutaneous coronary intervention(PCI). Methods 180 patients with myocardial infarction coronary heart disease without reflux after PCI were randomly divided into the observation group and the control group, 90 cases in each group. The control group received routine treatment such as anticoagulation, anti-platelet aggregation and myocardial nutrition. The observation group received compound Danshen dropping pills after PCI on the basis of routine treatment. Both groups continued to use for 3 months. The blood flow grading of thrombolytic therapy for myocardial infarction(TIMI) was compared between the two groups, and the total incidence of cardiac function and major long-term cardiovascular events was compared between the two groups. Results Compared with before treatment, the proportion of TIMI blood flow grading 0-2 in both groups decreased significantly and the proportion of TIMI blood flow grading 3 increased significantly after treatment(P<0.01), and the proportion of TIMI blood flow grading 0-2 in the observation group was significantly lower than that in the control group, and the proportion of grade 3 patients in the observation group was significantly higher than that in the control group(P<0.05). The level of LVEF in the observation group was significantly higher than that in the control group(P<0.01). The total incidence of major long-term cardiovascular events in the observation group was significantly lower than that in the control group(P<0.05). Conclusion Compound Danshen dropping pills can significantly improve myocardial microcirculation, improve cardiac function and reduce the total incidence of major long-term cardiovascular events in patients without cardiopulmonary bypass after PCI.