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

发布时间：2018-03-13 15:48

本文选题：血塞通注射液　切入点：经皮冠状动脉介入术　出处：《中国药房》2017年12期 　论文类型：期刊论文

【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 m L,术后给予血塞通注射液8 m L,加入0.9%氯化钠注射液250 m L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(c Tn T)、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、c Tn T、CKMB、PTX-3、hs-CRP、LVEF、LVEDD和BNP水平比较,差异均无统计学意义(P0.05)。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c Tn T、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(P0.05)。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(P0.05)。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(P0.05)。两组患者不良反应发生率比较,差异无统计学意义(P0.05)。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 investigate the effect of Xuesaitong injection before percutaneous coronary intervention (PCI) on the related indexes in patients with acute ST-segment elevation myocardial infarction (STEMI). Methods: the data of 112 patients with STEMI undergoing PCI were retrospectively analyzed. The control group (n = 64) and the observation group (n = 64) were treated with clopidogrel sulfate (300mg aspirin) immediately before PCI. The patients in the observation group were treated with Xuesaitong injection 8 mL by intravenous injection before operation, 8 mL by injection of Xuesaitong injection after operation, and by intravenous drip of 0.9% sodium chloride injection 250ml on the basis of treatment in the control group. The course of treatment was 14 days. The blood flow grade, myocardial coloration and MPG grade, cardiac troponin TnTn, creatine kinase isoenzyme (CK) and creatine kinase isoenzyme (CK) were observed before and 24 hours after thrombolytic therapy in both groups. 1 week after operation, the serum levels of normal pentagglutinin (PTX-3N), hypersensitive C-reactive protein (hs-CRP), left ventricular ejection fraction (LVEF), left ventricular end-diastolic volume (LVEDDN), brain natriuretic peptide (BNPP) and adverse reactions occurred 1 month before and 1 month after operation. There was no significant difference in the levels of BNP and TIMI between the two groups. 24 hours after operation, the TIMI blood flow grading of the two groups was significantly higher than that of the same group, and that of the observation group was significantly higher than that of the control group. The serum levels of cTnTnTnTncK-MB in the two groups were significantly lower than those in the same group before operation, and those in the observation group were significantly lower than those in the control group (P 0.05). At 1 week after operation, the serum levels of PTX-3hs-CRP in the two groups were significantly lower than those in the same group. The LVEF level of the two groups was significantly higher than that of the control group one month after operation, and that of the observation group was significantly higher than that of the control group, and that of the two groups was significantly lower than that of the same group before treatment. The incidence of adverse reactions in the observation group was significantly lower than that in the control group, and the difference was statistically significant (P 0.05). Conclusion: on the basis of routine treatment, Xuesaitong injection before PCI can significantly improve myocardial blood supply, reduce the level of inflammatory factors, alleviate myocardial injury and improve cardiac function in patients with STEMI. There was no increase in the incidence of adverse reactions.
【作者单位】：南阳市第二人民医院心内科;南阳市第二人民医院心血管内科一病区;
【分类号】：R542.22

【相似文献】