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复方丹参滴丸对急性ST段抬高型心肌梗死患者直接PCI疗效的影响

发布时间:2018-06-10 03:59

  本文选题:急性ST段抬高型心肌梗死 + 经皮冠状动脉介入治疗 ; 参考:《山西医科大学》2017年硕士论文


【摘要】:目的:探讨复方丹参滴丸对急性ST段抬高型心肌梗死(STEMI)患者直接经皮冠状动脉介入治疗(PCI)疗效的影响。方法:入选2015年1月-2016年10月山西大医院因初发急性STEMI并行直接PCI患者160例,采纳随机数字表法随机将其分为2组,试验组76人,对照组84人。对照组给予常规治疗,试验组在常规治疗基础上PCI术前服用复方丹参滴丸10丸,术后每日3次,每次10粒。记录PCI干预前、后IRA血流TIMI分级及校正的TIMI帧数(CTFC)、治疗期间不良心血管事件(MACE)发生率、术后即刻和3月后左心室射血分数(LVEF)和室壁运动记分指数(WMSI)的差异。结果:两组患者PCI干预前IRA血流TIMI分级无差异(P0.05),试验组患者PCI干预后IRA血流TIMI分级优于对照组(P0.05),试验组CTFC小于对照组(P0.05);试验组患者MACE发生率低于对照组(P0.05),但其中心源性休克发生率无统计学差异(P0.05);试验组患者术后3月LVEF及WMSI均较术后即刻或对照组有明显改善(P0.05)。结论:急性心肌梗死患者在冠心病二级预防药物治疗的基础上,PCI术前和术后服用复方丹参滴丸能更好地增加冠脉血流,减少MACE发生,提高左室射血分数,提示复方丹参滴丸可以改善心肌灌注,抑制心室重塑,改善左室功能,有助于患者长期预后。
[Abstract]:Objective: to investigate the effect of compound Danshen dropping pills on patients with acute ST-segment elevation myocardial infarction (STEMI) treated with direct percutaneous coronary intervention (PCI). Methods: 160 patients with primary acute STEMI and direct PCI in Shanxi Great Hospital from January 2015 to October 2016 were randomly divided into two groups: experimental group (n = 76) and control group (n = 84). The control group was treated with routine therapy, the experimental group took 10 pills of compound Danshen drop pills before PCI, 10 pills per day three times a day after PCI. Before and after PCI intervention, the TIMI grading of IRA blood flow and the corrected TIMI frame count were recorded. The incidence of adverse cardiovascular events (MACEC), left ventricular ejection fraction (LVEF) and ventricular wall motion score index (WMSI) were compared immediately and 3 months after PCI. Results: there was no difference in TIMI grade of IRA blood flow between the two groups before PCI intervention. After PCI intervention, the TIMI grade of IRA blood flow in the trial group was better than that in the control group (P 0.05), the CTFC in the trial group was lower than that in the control group (P 0.05), the incidence of Mace in the trial group was lower than that in the control group (P 0.05), but the rate of Mace in the trial group was lower than that in the control group. There was no significant difference in the incidence of cardiogenic shock (P 0.05). LVEF and WMSI were significantly improved 3 months after operation in the trial group compared with those in the control group or immediately after operation. Conclusion: taking compound salvia miltiorrhiza drop pill before and after PCI can increase coronary blood flow, reduce Mace and increase left ventricular ejection fraction in patients with acute myocardial infarction. The results suggest that compound Danshen dropping pill can improve myocardial perfusion, inhibit ventricular remodeling, improve left ventricular function, and contribute to the long-term prognosis of patients.
【学位授予单位】:山西医科大学
【学位级别】:硕士
【学位授予年份】:2017
【分类号】:R542.22

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