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目的探讨苦碟子注射液对行经皮冠状动脉介入治疗(PCI)的急性心肌梗死(AMI)患者的影响。方法选取2015年7月—2016年7月在新疆心脑血管病医院心血管内科行PCI的AMI患者124例,采用随机数字表法分为对照组和观察组,每组62例。对照组患者PCI前行常规治疗,观察组患者在对照组基础上给予苦碟子注射液;两组患者均持续用药至PCI后2周。比较两组患者PCI后1 h TIMI分级、PCI后1周ST段回落情况、随访6个月主要不良心血管事件(MACE)发生情况、PCI前及PCI后1 h心肌损伤标志物[肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(c Tn I)]、PCI前及PCI后2周氧化应激反应指标[丙二醛(MDA)、超氧化物歧化酶(SOD)]及血清内皮素1(ET-1)水平。结果观察组患者中PCI后1 h TIMI分级3级者所占比例高于对照组(P<0.05);两组患者PCI后1周ST段回落>50%者所占比例比较,差异无统计学意义(P>0.05);观察组患者随访6个月MACE发生率低于对照组(P<0.05)。两组患者PCI前血清CK-MB、c Tn I水平比较,差异无统计学意义(P>0.05);PCI后1 h观察组患者血清CK-MB、c Tn I水平低于对照组(P<0.05)。两组患者PCI前血清MDA、SOD水平比较,差异无统计学意义(P>0.05);PCI后2周观察组患者血清MDA水平低于对照组,血清SOD水平高于对照组(P<0.05)。两组患者PCI前血清ET-1水平比较,差异无统计学意义(P>0.05);PCI后2周观察组患者血清ET-1水平低于对照组(P<0.05)。结论苦碟子注射液能有效改善AMI患者PCI后心肌灌注,减轻心肌损伤及氧化应激反应,降低血清ET-1水平及MACE发生率。
Objective To investigate the effect of Kudiezi Injection on patients with acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI). Methods From July 2015 to July 2016, 124 patients with PCI AMI were enrolled in the Department of Cardiology, Xinjiang Cardiovascular and Cardiovascular Hospital, and divided into control group and observation group with 62 cases in each group. Patients in the control group were treated with conventional PCI before treatment. Patients in the observation group were given Kudiezi injection on the basis of the control group. Patients in both groups continued to receive medication until 2 weeks after PCI. TIMI classification at 1 hour after PCI and ST-segment depression at 1 week after PCI were compared between two groups. The occurrence of major adverse cardiovascular events (MACE) at 6 months follow-up, myocardial injury markers [creatine kinase CK-MB, cTn I), indicators of oxidative stress (MDA, SOD) before PCI and 2 weeks after PCI And serum endothelin 1 (ET-1) levels. Results In the observation group, the proportion of grade 3 TIMI grade 1 at 1 h after PCI was significantly higher than that of the control group (P <0.05). There was no significant difference between the two groups in the percentage of ST segment falling> 50% at 1 week after PCI (P> 0.05). The incidence of MACE in observation group was lower than that in control group at 6 months of follow-up (P <0.05). The levels of CK-MB and cTnI in pre-PCI serum of the two groups were not significantly different (P> 0.05). The levels of CK-MB and cTnI in the observation group at 1 hour after PCI were lower than those in the control group (P < 0.05). There was no significant difference in the level of serum MDA and SOD before PCI between the two groups (P> 0.05). The level of MDA in the observation group was lower than that in the control group at 2 weeks after PCI, and the serum SOD level was higher than that in the control group (P <0.05) . The serum levels of ET-1 in PCI group before PCI were not significantly different between the two groups (P> 0.05). The ET-1 level in the two groups after PCI was lower than that in the control group (P <0.05). Conclusion Kudiezi Injection can effectively improve myocardial perfusion, reduce myocardial injury and oxidative stress in patients with AMI, reduce serum ET-1 level and MACE incidence.