PCI术前应用血塞通注射液对急性ST段抬高型心肌梗死患者相关指标的影响
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篇名: PCI术前应用血塞通注射液对急性ST段抬高型心肌梗死患者相关指标的影响
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摘要: 目的:探讨经皮冠状动脉介入(PCI)术前应用血塞通注射液对急性ST段抬高型心肌梗死(STEMI)患者相关指标的影响。方法: 回顾性分析行PCI术的112例STEMI患者资料,按治疗方式的不同分为对照组(48例)和观察组(64例)。对照组患者行PCI术前即刻口服硫酸氯吡格雷片300 mg+阿司匹林肠溶片300 mg,术后根据患者病情改善情况给予常规治疗;观察组患者在对照组治疗的基础上于术前静脉推注血塞通注射液8 mL,术后给予血塞通注射液8 mL,加入0.9%氯化钠注射液250 mL中,静脉滴注,每日1次。两组疗程均为14 d。观察两组患者术前、术后24 h 心肌梗死溶栓治疗(TIMI)血流分级、心肌显色(MPG)分级、心肌肌钙蛋白T(cTnT)、肌酸激酶同工酶(CKMB),术前、术后1周血清正五聚蛋白-3(PTX-3)、超敏C反应蛋白(hs-CRP)水平,术前、术后1个月左心室射血分数(LVEF)、左心室舒张末期容积(LVEDD)、脑利钠肽(BNP)及不良反应发生情况。结果:术前,两组患者TIMI血流分级、MPG分级、cTnT、CKMB、PTX-3、hs-CRP、LVEF、LVEDD和BNP水平比较,差异均无统计学意义(P>0.05)。术后24 h,两组患者TIMI血流分级、MPG分级均显著高于同组术前,且观察组显著高于对照组;两组患者血清cTnT、CKMB水平均显著低于同组术前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。术后1周,两组患者血清PTX-3、hs-CRP水平均显著低于同组术前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。术后1个月,两组患者LVEF水平均显著高于同组术前,且观察组显著高于对照组;两组患者LVEDD、BNP水平均显著低于同组治疗前,且观察组显著低于对照组,差异均有统计学意义(P<0.05)。 两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:在常规治疗的基础上, PCI术前给予血塞通注射液可显著改善STEMI患者心肌血供,降低炎症因子水平,减轻心肌损伤,改善心功能,且未增加不良反应的发生。
ABSTRACT: OBJECTIVE: To explore the effects of Xuesaitong injection on related indexes of patients with acute ST segment elevation myocardial infarction (STEMI) before percutaneous coronary intervention (PCI). METHODS: 112 STEMI patients underwent PCI were analyzed retrospectively and divided into control group (48 cases) and observation group (64 cases) according to different treatment methods. Control group was given Clopidogrel sulfate tablets 300 mg and Aspirin enteric-coated tablets 300 mg orally before PCI; given conventional treatment according to patients’ condition after surgery. Observation group additionally received intravenous push of Xuesaitong injection 8 mL before surgery, and Xuesaitong injection 8 mL added into Sodium chloride 250 mL intravenously, once a day after surgery, on the basis of control group. Treatment course of 2 groups lasted for 14 d. TIMI level, MPG level, the serum levels of cTnT, CKMB were observed in 2 groups before surgery, 24 h after surgery; serum level of PTX-3, hs-CRP were observed before surgery, one week after surgery; LVEF, LVEDD, serum level of BNP were observed before surgery and one month after surgery; the occurrence of ADR was observed to. RESULTS: Before surgery, there was no statistical significance in TIMI level, MPG level, the serum levels of cTnT, CKMB, PTX-3 and hs-CRP, LVEF, LVEDD, serum level of BNP between 2 groups (P>0.05). 24 h after surgery, TIMI level and MPG level of 2 groups were significantly higher than before, and the observation group was significantly higher than the control group; the serum levels of cTnT and CKMB in 2 groups were significantly lower than before, and the observation group was significantly lower than the control group, with statistical significance (P<0.05). One week after surgery, the serum levels of PTX-3 and hs-CRP in 2 groups were significantly lower than before surgery, and the observation group was significantly lower than the control group, with statistical significance (P<0.05). One month after surgery, the level of LVEF in 2 groups were significantly higher than before surgery, and the observation group was significantly higher than the control group; LVEDD and serum level of BNP in 2 groups were significantly lower than before surgery, and the observation group was significantly lower than the control group, with statistical significance (P<0.05). There was no statistical significance in the incidence of ADR between 2 groups (P>0.05). CONCLUSIONS: Based on conventional treatment, Xuesaitong injection can effectively improve myocardial blood supply before PCI, decrease the level of inflammatory factor, relieve myocardial injury, improve cardiac function without increasing the incidence of ADR.
期刊: 2017年第28卷第12期
作者: 孙晓溪,胡东旭,刘洋
AUTHORS: SUN Xiaoxi,HU Dongxu,LIU Yang
关键字: 血塞通注射液;经皮冠状动脉介入术;急性ST段抬高型心肌梗死;炎症;心功能
KEYWORDS: Xuesaitong injection; Percutaneous coronary intervention; Acute ST segment elevation myocardial infarction; Inflammation; Cardiac function
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