摘要
目的:探究远端缺血预适应联合丹红注射液对急诊PCI术心肌保护的临床价值.方法:选择2017年8月-2019年6月在本院住院的急性ST段抬高型心肌梗死已行急诊PCI术的60例患者作为研究对象.将其按照不同的治疗方法分为观察组(n=20)与对照组(n=40),对照组分为丹红组(n=20)和常规组(n=20).观察组在术前行远端缺血预适应及术后使用丹红注射液进行治疗,常规组参照临床路径给予相应的西药治疗,丹红组在常规治疗的基础上加用丹红注射液.观察患者术中心律失常发生率、再灌注后10 min内胸痛缓解情况,手术前后谷胱甘肽过氧化物酶(GSH-Px)、超氧化物歧化酶(SOD)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)的变化,以及术后7 d、1个月心输出量(CO)、N端前体脑钠肽(NT-proBNP)、射血分数(EF)及室壁运动指数(WNSI).结果:观察组术中三种心律失常发生率与对照组比较,差异均有统计学意义(P<0.05);观察组胸痛症状明显缓解人数与对照组比较,差异有统计学意义(P<0.01).术后12 h,观察组GSH-Px、SOD、CK-MB与丹红组比较,CK-MB与常规组比较,差异均有统计学意义(P<0.05);术后24 h,观察组GSH-Px、SOD、CK-MB与丹红组、常规组比较,差异均有统计学意义(P<0.05);术后7 d,观察组GSH-Px、cTnI与常规组比较,差异均有统计学意义(P<0.05),丹红组cTnI与常规组比较,差异有统计学意义(P<0.05).术后7 d,观察组EF高于常规组(P<0.05);术后1个月,观察组CO、EF均高于常规组(P<0.05),WMSI、NT-proBNP均明显低于常规组(P<0.05),丹红组NT-proBNP低于常规组(P<0.05).结论:远端缺血预适应联合丹红注射液治疗急诊PCI术患者,可以减少心肌再灌注损伤,改善心功能,有较好的临床应用价值.
Objective:To investigate the clinical value of distal ischemic preconditioning combined with Danhong Injection on myocardial protection in emergency PCI.Method:From August 2017 to June 2019,60 patients with acute ST-enhanced myocardial infarction treated in our hospital and underwent emergency PCI were selected as the objects,they were divided into the observation group(n=20)and the control group(n=40)according to the different treatment methods,the control group was divided into the conventional group(n=20)and the Danhong group(n=20).The observation group underwent distal ischemic preconditioning and postoperative treatment with Danhong Injection,the routine group was treated with western medicine according to the clinical pathway,the Danhong group was given Danhong Injection on the basis of the routine treatment.The incidence of cardiac arrhythmia during the operation and the relief of chest pain of patients were observed,the changes of glutathione peroxidase(GSH-Px),superoxide dismutase(SOD),creatine kinase isoenzyme(CK-MB),and cardiac troponin I(cTnI)before and after surgery were observed,and the cardiac output(CO),NT-proBNP,ejection fraction(EF),and abnormal wall motion(WNSI)at 7 d and 1 month after surgery.Result:Ccompared with the control group,the incidence of three kinds of arrhythmias in the observation group during the operation were statistically significant(P<0.05).The number of patients in the observation group with chest pain symptoms alleviated significantly compared with the control group(P<0.01).At 12 h after operation,GSH-Px,SOD,CK-MB in the observation group were compared with Danhong group,and CK-MB was compared with the routine group,the differences were statistically significant(P<0.05).At 24 h after operation,GSH-Px,SOD and CK-MB in the observation group were significantly different from those in the Danhong group and the conventional group(P<0.05).7 d after operation,GSH-Px and cTnI in the observation group compared with the control group,there were statistical significance(P<0.05),and cTnI in the Danhong group compared with the conventional group,there was statistical significance(P<0.05).At 7 d after operation,the EF of the observation group was higher than that of the conventional group(P<0.05).At 1 month after operation,the CO and EF of the observation group were higher than those of the conventional group(P<0.05),WMSI and NT-proBNP were significantly lower than those of the conventional group(P<0.05),and NT-proBNP of the Danhong group was lower than that of the conventional group(P<0.05).Conclusion:Distal ischemic preconditioning combined with Danhong Injection in the treatment of emergency PCI patients can reduce myocardial reperfusion injury and improve cardiac function,it has a good clinical application value.
作者
吴金飞
陈小芳
王强
熊宁
吴筠青
黄永芳
周美灵
韦丽萍
WU Jinfei;CHEN Xiaofang;WANG Qiang;XIONG Ning;WU Yunqing;HUANG Yongfang;ZHOU Meiling;WEI Liping(The 184th Hospital of the People’s Liberation Army,Yingtan 335000,China)
出处
《中国医学创新》
CAS
2020年第20期18-22,共5页
Medical Innovation of China
基金
鹰潭市科技计划项目(SF201719)。
关键词
远端缺血预适应
丹红注射液
急诊PCI
再灌注损伤
Distal ischemic preconditioning
Danhong Injection
Emergency PCI
Reperfusion injury
