丹参酮ⅡA磺酸钠联合促红细胞生成素对急性ST段抬高型心肌梗死患者PCI术后心功能的影响

Effect of Sodium Tanshinone ⅡA Sulfonate Combined with Erythropoietin on Cardiac Function in Patients with Acute ST-segment Elevation Myocardial Infarction after PCI

目的探究丹参酮ⅡA磺酸钠联合促红细胞生成素对急性ST段抬高型心肌梗死(ASTEMI)患者经皮冠状动脉介入(PCI)术后心功能的影响。方法方便选取2013年11月-2018年10月该院60例ASTEMI患者,按照治疗方案分组,各30例。两组均行PCI术,对照组予以促红细胞生成素治疗,观察组在对照组基础上予以丹参酮ⅡA磺酸钠治疗。对比两组不良心血管事件发生率、治疗前后心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)]、总ST(ΣST)抬高导联个数、ΣST抬高幅度、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白Ⅰ(cTnⅠ)水平。结果治疗后观察组LVEF(53.84±4.76)%较对照组(48.61±4.25)%高(t=4.489,P=0.000),LVEDD(37.11±3.03)mm、LVESD(45.84±3.03)mm较对照组(42.59±3.38)mm、(52.69±4.01)mm低(t=6.612,P=0.000,t=7.465,P=0.000);治疗后观察组ΣST导联(1.46±0.31)个较对照组(2.13±0.48)个少,ΣST幅度(3.39±0.44)mm较对照组(5.87±0.68)mm低(t=6.422,P=0.000,t=16.771,P=0.000);治疗后观察组血清cTnⅠ (1.13±0.36)ng/mL、CK (80.46±11.78)U/L、CK-MB(7.95±2.81)U/L水平较对照组(2.29±0.41)ng/mL、(145.32±14.94)U/L、(15.46±3.52)U/L低(t=11.645,P=0.000,t=18.672,P=0.000,t=9.133,P=0.000);观察组不良心血管事件发生率10.00%(3/30)较对照组33.33%(10/30)低(t=4.812,P=0.028),以上各项对比均差异有统计学意义。结论丹参酮IIA磺酸钠联合促红细胞生成素治疗PCI术后ASTEMI患者,可增强患者心功能,改善心电图表现,降低血清cTnⅠ、CK、CK-MB水平,有助于减轻心肌损伤,减少不良心血管事件发生。

Objective To investigate the effect of sodium tanshinone ⅡA sulfonate combined with erythropoietin on cardiac function in patients with acute ST-segment elevation myocardial infarction(ASTEMI) after percutaneous coronary intervention(PCI). Methods Convenient selected sixty patients with ASTEMI were enrolled in the hospital from November 2013 to October 2018. According to the treatment plan, 30 patients each. PCI was performed in both groups, and the control group was treated with erythropoietin. The observation group was treated with sodium tanshinone ⅡA sulfonate on the basis of the control group. Comparing the incidence of adverse cardiovascular events, cardiac function indicators before and after treatment [LVEF, left ventricular end-diastolic diameter(LVEDD), left ventricular end-systolic diameter(LVESD)], total ST(ΣST) elevation The number of high leads, ST elevation, creatine kinase(CK), creatine kinase isoenzyme(CK-MB), and troponin Ⅰ(cTnⅠ) levels. Results After treatment, the LVEF(53.84±4.76)% was higher than the control group(48.61±4.25)%(t=4.489, P=0.000), LVEDD(37.11±3.03) mm, LVESD(45.84±3.03)mm compared with the control group(42.59±3.38)mm,(52.69±4.01)mm lower(t=6.612, P=0.000, t=7.465, P=0.000);after treatment, the ST lead(1.46±0.31) in the observation group was compared with the control group(2.13±0.48). The number of sputum ST(3.39±0.44) mm was lower than that of the control group(5.87±0.68) mm(t=6.422, P=0.000, t=16.771, P=0.000);serum cTnⅠ(1.13±0.36)ng/mL, CK(80.46±11.78)U/L, CK-MB(7.95±2.81) U/L was observed after treatment compared with the control group(2.29 ±0.41) ng/mL,(145.32±14.94) U/L,(15.46±3.52) U/L lower(t=11.645, P=0.000,t=18.672, P=0.000, t =9.133, P =0.000);the incidence of adverse cardiovascular events in the observation group was 10.00%(3/30) compared with the control group. The group was 33.33%(10/30) low(t=4.812, P=0.028). All the above comparisons showed statistically significant difference. Conclusion Tanshinone ⅡA sulfonate combined with erythropoietin in the treatment of patients with ASTEMI after PCI can enhance cardiac function, improve ECG performance, reduce serum cTnⅠ, CK, CK-MB levels, help reduce myocardial damage and reduce adverse cardiovascular event.