血府逐瘀汤对STEMI病人PCI术后炎症指标、再灌注后心功能及生存质量的影响

Effect of Xuefu Zhuyu Decoction on Inflammation Indicators, Cardiac Function and Quality of Life after PCI in STEMI Patients

目的:探讨血府逐瘀汤对ST段抬高型心肌梗死(STEMI)病人经皮冠状动脉介入治疗(PCI)术后炎症指标及再灌注后心功能及生存质量的影响。方法:选取2020年1月1日—2021年12月31日于我院接受PCI治疗的STEMI病人244例作为研究对象,采用计算机随机化法分为研究组和对照组,每组122例。研究组给予血府逐瘀汤+PCI术后常规基础治疗,对照组给予PCI术后常规基础治疗,两组病人均随访6个月。对比两组主要心脑血管不良事件(MACCE)发生情况、心肌梗死多维度量表(MIDAS)评分、美国纽约心脏协会(NYHA)心功能分级、不良反应发生情况、中医临床症状积分、中医证候疗效、左心室重构情况及炎性因子[白细胞介素-6(IL-6)、内皮素-1(ET-1)、一氧化氮(NO)以及基质金属蛋白酶-9(MMP-9)]水平。结果:研究组MACCE总发生率低于对照组,NYHA心功能分级改善情况优于对照组,中医证候疗效优于对照组(P<0.05)。治疗后,两组MIDAS评分均较治疗前降低,且研究组低于对照组(P<0.05)。治疗后,两组中医临床症状积分均较治疗前下降,且研究组低于对照组(P<0.05)。治疗后,两组左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)降低,左室射血分数(LVEF)升高,且研究组LVESD、LVEDD低于对照组,LVEF高于对照组(P<0.05)。治疗后,两组IL-6、ET-1、MMP-9降低,NO升高,且研究组IL-6、ET-1、MMP-9低于对照组,NO高于对照组(P<0.05)。结论:血府逐瘀汤应用于STEMI病人PCI术后能显著提高病人的整体生存质量,降低MACCE发生风险,改善心功能,减轻炎症反应,有利于病人预后。

Objective:To investigate the effects of Xuefu Zhuyu decoction on inflammation indicators,cardiac function and quality of life after percutaneous coronary intervention(PCI)in ST segment elevation myocardial infarction(STEMI)patients.Methods:A total of 244 STEMI patients after PCI were selected as the study subjects and randomly divided into experimental group and control group,with 122 cases in each group.The experimental group received Xuefu Zhuyu decoction+routine basic treatment alone after PCI,while the control group received routine basic treatment alone after PCI.Both groups were followed up for 6 months.The occurrence of major cardiovascular and cerebrovascular adverse events(MACCE),myocardial Infarction Multidimensional Scale(MIDAS)score,New York Heart Association(NYHA)cardiac function grade,adverse reaction occurrence,clinical symptom score of traditional Chinese medicine(TCM),TCM syndrome efficacy,left ventricular remodeling index,and inflammatory factor level[interleukin-6(IL-6),endothelin-1(ET-1),nitric oxide(NO),and matrix metalloproteinase-9(MMP-9)]in the two groups were analyzed and compared before and after treatment.Results:After treatment,the total incidence of MACCE in the experimental group was lower than that in the control group,the improvement of NYHA cardiac function grade was better than that in the control group,and the curative effect of TCM syndrome was higher than that in the control group(P<0.05).After treatment,MIDAS scores in both groups were lower than that before treatment,and that in the experimental group was lower than that of the control group(P<0.05).After treatment,TCM symptom scores of both groups were lower than that before treatment,and that the experimental group was lower than that of the control group(P<0.05).After treatment,left ventricular end-systolic diameter(LVESD)and left ventricular end diastolic diameter(LVEDD)decreased and left ventricular ejection fraction(LVEF)increased in the two groups,and LVESD and LVEDD in the experimental group were lower than those in the control group,while LVEF was higher than that in the control group(P<0.05).After treatment,IL-6,ET-1 and MMP-9 decreased and NO increased in both groups,and IL-6,ET-1 and MMP-9 in the experimental group were lower than those in the control group,and NO were higher than those in the control group(P<0.05).Conclusion:The application of Xuefu Zhuyu decoction in STEMI patients after PCI can significantly improve overall survival quality,reduce the risk of MACE occurrence,improve cardiac function,and alleviate inflammatory reactions,which are beneficial for patient prognosis.