冠心宁片对急性心肌梗死经皮冠脉介入术后患者心肌灌注水平及炎症反应的影响

Effects of Guanxinning tablet on myocardial perfusion and inflammatory response in patients with acute myocardial infarction after percutaneous coronary intervention

摘要:

目的 探讨冠心宁片对急性心肌梗死经皮冠脉介入术（PCI）后患者心肌灌注水平及炎症反应的影响。方法 选取2019年1月—2020年8月中国人民解放军陆军第七十二集团军医院收治的急性心肌梗死患者120例，均行PCI治疗。采用随机表法分为观察组与对照组，每组60例。对照组术前口服阿司匹林、替格瑞洛，术后均皮下注射依诺肝素注射液4 000 u/次，3～5d，术后长期口服阿司匹林、替格瑞洛。观察组在对照组基础上术前加用冠心宁，术后继续服用冠心宁片4片/次，3次/d。比较两组术后心肌血流灌注分级（TIMI），治疗前后心功能和炎症因子变化及疗效。结果 观察组TIMI血流3级率高于对照组（P <0.05）。观察组治疗前后左心室射血分数、左心室收缩末期内径和左心室舒张末期内径的差值大于对照组（P <0.05）。观察组治疗前后血清C反应蛋白、白细胞介素-6和肿瘤坏死因子-α水平的差值大于对照组（P <0.05）。观察组治疗前后NIHSS评分的差值大于对照组（P <0.05）。观察组总有效率高于对照组（P <0.05）。结论 冠心宁片对急性心肌梗死PCI术后患者疗效良好，可明显改善心肌灌注水平，减轻炎症反应。

Abstract:

Objective To investigate the effects of Guanxinning tablet on myocardial perfusion and inflammatory response in patients with acute myocardial infarction after percutaneous coronary intervention (PCI).Methods The 120 patients with acute myocardial infarction undergoing PCI admitted to our hospital from January 2019 to August 2020 were selected, and randomly divided into observation group and control group with 60 cases in each group. The control group was given aspirin and ticagrelor before the procedure, and subcutaneously injected with 4 000 u of enoxaparin at a time for 3 to 5 days and orally administrated aspirin and ticagrelor for a long time after the procedure. The observation group was additionally given Guanxinning tablets on the basis of the control group before operation, and continued to take 4 Guanxinning tablets at a time, 3 times a day after operation. The Thrombolysis In Myocardial Infarction (TIMI) myocardial perfusion grade after operation, changes of cardiac function and inflammatory factors before and after treatment, and therapeutic effect were compared between the two groups.Results The percentage of TIMI grade 3 flow in the observation group was higher than that in the control group (P < 0.05). The differences of left ventricular ejection fraction (LVEF), left ventricular end-systolic dimension (LVDs) and left ventricular end-diastolic dimension (LVDd) before and after treatment in the observation group were higher than those in the control group (P < 0.05). The differences of serum C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) levels before and after treatment in the observation group were higher than those in the control group (P < 0.05). The difference of National Institutes of Health Stroke Scale (NIHSS) score before and after treatment was higher in the observation group compared with the control group (P < 0.05). The overall effective rate of the observation group was higher than that of the control group (P < 0.05).Conclusions Guanxinning tablet has a good curative effect on patients with acute myocardial infarction after PCI, which can significantly improve myocardial perfusion and reduce inflammatory response.