發(fā)布時間：2018-03-13 15:48

  本文選題：血塞通注射液　切入點：經(jīng)皮冠狀動脈介入術(shù)　出處：《中國藥房》2017年12期 　論文類型：期刊論文

【摘要】：目的:探討經(jīng)皮冠狀動脈介入(PCI)術(shù)前應用血塞通注射液對急性ST段抬高型心肌梗死(STEMI)患者相關(guān)指標的影響。方法:回顧性分析行PCI術(shù)的112例STEMI患者資料,按治療方式的不同分為對照組(48例)和觀察組(64例)。對照組患者行PCI術(shù)前即刻口服硫酸氯吡格雷片300 mg+阿司匹林腸溶片300 mg,術(shù)后根據(jù)患者病情改善情況給予常規(guī)治療;觀察組患者在對照組治療的基礎(chǔ)上于術(shù)前靜脈推注血塞通注射液8 m L,術(shù)后給予血塞通注射液8 m L,加入0.9%氯化鈉注射液250 m L中,靜脈滴注,每日1次。兩組療程均為14 d。觀察兩組患者術(shù)前、術(shù)后24 h心肌梗死溶栓治療(TIMI)血流分級、心肌顯色(MPG)分級、心肌肌鈣蛋白T(c Tn T)、肌酸激酶同工酶(CKMB),術(shù)前、術(shù)后1周血清正五聚蛋白-3(PTX-3)、超敏C反應蛋白(hs-CRP)水平,術(shù)前、術(shù)后1個月左心室射血分數(shù)(LVEF)、左心室舒張末期容積(LVEDD)、腦利鈉肽(BNP)及不良反應發(fā)生情況。結(jié)果:術(shù)前,兩組患者TIMI血流分級、MPG分級、c Tn T、CKMB、PTX-3、hs-CRP、LVEF、LVEDD和BNP水平比較,差異均無統(tǒng)計學意義(P0.05)。術(shù)后24 h,兩組患者TIMI血流分級、MPG分級均顯著高于同組術(shù)前,且觀察組顯著高于對照組;兩組患者血清c Tn T、CKMB水平均顯著低于同組術(shù)前,且觀察組顯著低于對照組,差異均有統(tǒng)計學意義(P0.05)。術(shù)后1周,兩組患者血清PTX-3、hs-CRP水平均顯著低于同組術(shù)前,且觀察組顯著低于對照組,差異均有統(tǒng)計學意義(P0.05)。術(shù)后1個月,兩組患者LVEF水平均顯著高于同組術(shù)前,且觀察組顯著高于對照組;兩組患者LVEDD、BNP水平均顯著低于同組治療前,且觀察組顯著低于對照組,差異均有統(tǒng)計學意義(P0.05)。兩組患者不良反應發(fā)生率比較,差異無統(tǒng)計學意義(P0.05)。結(jié)論:在常規(guī)治療的基礎(chǔ)上,PCI術(shù)前給予血塞通注射液可顯著改善STEMI患者心肌血供,降低炎癥因子水平,減輕心肌損傷,改善心功能,且未增加不良反應的發(fā)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.
【作者單位】： 南陽市第二人民醫(yī)院心內(nèi)科;南陽市第二人民醫(yī)院心血管內(nèi)科一病區(qū);
【分類號】：R542.22

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