丹参滴丸联合强化降脂治疗对急性心肌梗死PCI术后再梗死的预防作用研究

发布时间：2018-03-17 20:16

本文选题：丹参滴丸　切入点：强化降脂治疗　出处：《中华中医药学刊》2017年10期 　论文类型：期刊论文

【摘要】：目的:探讨丹参滴丸联合强化降脂治疗对急性心肌梗死PCI术后再梗死的预防作用。方法:选取医院自2014年4月—2014年11月确诊的急性ST段抬高型心肌梗死行PCI术患者104例,根据随机数字表法进行分组,对照组52例予以术后予以常规降脂治疗,控制原发病等常规治疗,研究组52例在常规治疗上予以丹参滴丸(10丸/次,tid)联合强化降脂(阿托伐他汀钙片80 mg/d,qd)治疗,3个月为1疗程。用药前、介入后24 h及介入后7 d采血测定血清细胞因子、心肌损伤标志物及血管内皮功能指标,对比两组间心肌微循环灌注状况,进行2年的随访,观察并记录心血管事件。结果:经单因素方差分析,与用药前比较,两组用药不同时间点血清细胞因子、心肌损伤及血管内皮功能指标存在差异(P0.05);与对照组比较,研究组介入后24 h、介入后7 d时血清CRP、TNF-α、IFN-γ、IL-6含量较低,血清CK-MB、c Tn I、BNP含量较低,血清ET、s ICAM-1含量较低,NO含量较高(P0.05);研究组用药后心肌微循环灌注改善程度更高(P0.05);随访2年期间无病例脱落现象,两组间心血管事件对比,无差异(P0.05)。结论:丹参滴丸联合强化降脂治疗对急性心肌梗死PCI术后心肌保护作用较强,抑制手术导致的炎症反应及血管内皮损伤,改善心肌微循环灌注。
[Abstract]:Objective: to investigate the preventive effect of Danshen dropping pill combined with enhanced lipid-lowering therapy on reinfarction after acute myocardial infarction (PCI). Methods: 104 patients with acute ST-segment elevation myocardial infarction diagnosed from April 2014 to November 2014 in our hospital were treated with PCI. According to the random digital table method, 52 patients in the control group were treated with conventional lipid-lowering therapy and control of primary disease. 52 patients in the study group were treated with Danshen dropping pills 10 pills / times tid combined with enhanced lipid lowering (80 mg / d QD of Atto vastatin calcium tablets) for 3 months. Serum cytokines were measured 24 hours before intervention 24 hours after intervention and 7 days after intervention. Myocardial injury markers and vascular endothelial function indexes were compared between the two groups, followed up for 2 years, cardiovascular events were observed and recorded. There were significant differences in serum cytokines, myocardial injury and vascular endothelial function between the two groups at different time points (P 0.05), compared with the control group, the levels of serum CRPn- TNF- 伪 IFN- 纬 IL-6 and serum CK-MBC Tn I BNP in the study group were lower than those in the control group at 24 hours after intervention and 7 days after intervention. The content of serum ETS ICAM-1 was lower and the content of no was higher than that of control group (P 0.05). The myocardial microcirculation perfusion in the study group was improved significantly (P 0.05). There was no case abscission during the follow-up of 2 years, and the cardiovascular events were compared between the two groups. Conclusion: Salvia miltiorrhiza drop pill combined with enhanced lipid-lowering therapy has a strong protective effect on myocardium after acute myocardial infarction (PCI). It can inhibit the inflammatory reaction and vascular endothelial injury induced by operation and improve myocardial microcirculation perfusion.
【作者单位】：海南省农垦三亚医院(海南省第三人民医院)心内科;
【基金】：三亚医疗卫生科技创新项目(YW1214)
【分类号】：R542.22

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