生脉注射液对冠心病三支病变患者急诊PCI术后心脏自主神经功能和心肌微循环的影响  

Effect of Shengmai Injection on Cardiac Autonomic Nervous Function and Myocardial Microcirculation in Patients with Three-vessel Lesions of Coronary Heart Disease after Emergency PCI

作　　者：黄斌 陆猛桂[2] HUANG Bin;LU Menggui(Emergency Department,The First People's Hospital of Yulin,Yulin 537000,Guangxi,China;Nephrology Department,The First People's Hospital of Yulin,Yulin 537000,Guangxi,China)

机构地区：[1]玉林市第一人民医院急诊科,广西玉林537000 [2]玉林市第一人民医院肾内科,广西玉林537000

出　　处：《辽宁中医杂志》2020年第1期120-123,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：国家自然科学基金地区科学基金项目(81560792).

摘　　要：目的生脉注射液对冠心病(CHD)三支病变患者急诊经皮冠状动脉介入术(PCI)术后心脏自主神经功能和心肌微循环的影响。方法选取2015年1月—2018年1月医院收治的经皮冠状动脉造影术(CAG)提示严重三支病变的CHD患者72例作为研究对象,均行急诊PCI,采用随机数字表法分为对照组和观察组,每组各36例。对照组PCI术后给予常规治疗,观察组在对照组基础上给予生脉注射液治疗,两组疗程为7 d。记录支架置入情况、心肌梗死溶栓试验(TIMI)分级、TIMI心肌灌注分级(TMPG)3级及左前降支(LAD)、左回旋支(LCX)、右冠状动脉(RCA)校正TIMI血流帧数计数(CTFC),并观察PCI术后超声心动图指标[左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)]和心率变异性(HRV)指标[心率变异性时域指标R-R间期总标准差(SDNN)、窦性R-R间期平均值标准差(SDANN)、两个相邻R-R间期互差>50 ms的心跳所占分析信息内心跳数的百分数(PNN50%)]变化,检测超氧化物歧化酶(SOD)、丙二醛(MDA)、白介素6(IL-6)、超敏C反应蛋白(hs-CRP)水平。结果两组支架置入情况比较差异无统计学意义(P>0.05);观察组术后7d TIMI分级、TMPG 3级几率比较,差异无统计学意义(P>0.05);观察组术后7 d LAD CTFC、LCX CTFC、RCA CTFC少于对照组,LVESD、LVEDD低于对照组,LVEF高于对照组(P<0.05);观察组术后7 d SDNN、SDANN、PNN50%均高于对照组(P<0.05);观察组术后7 d MDA、IL-6、hs-CRP低于对照组,SOD高于对照组(P<0.05)。结论冠心病三支病变患者急诊PCI术后给予生脉注射液,可降低炎性因子水平,减轻氧化氧化应激反应,改善心脏自主神经功能和心肌微循环。Objective The effect of Shengmai Injection on cardiac autonomic nervous function and myocardial microcirculation in patients with three-vessel lesions of coronary heart disease(CHD)after emergency percutaneous coronary intervention(PCI).Methods A total of 72 patients with severe three-vessel lesions of CHD who underwent percutaneous coronary angiography(CAG)in the hospital from January 2015 to January 2018 were enrolled in the study.All patients underwent emergency PCI and they were randomly divided into control group and observation groups,36 patients in each group.The control group was given routine treatment after PCI,and the observation group was treated with Shengmai Injection on the basis of the treatment for control group.The course of treatment for both groups was 7 days.The condition of stent placement,grade 3 thrombolysis in myocardial infarction(TIMI)and TIMI myocardial perfusion(TMPG),left anterior descending artery(LAD),left circumflex artery(LCX),right coronary artery(RCA)corrected TIMI frame count(CTFC)were recorded.Changes in echocardiogram parameters[left ventricular ejection fraction(LVEF),left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)]and heart rate variability(HRV)indicators[standard deviation of normal RR intervals(SDNN),standard deviation of 5 min average normal RR intervals(SDANN),percent of NN50 in the total number of RR intervals(PNN50%)]after PCI were observed.Levels of superoxide dismutase(SOD),malondialdehyde(MDA),interleukin 6(IL-6)and high-sensitivity C-reactive protein(hs-CRP)were detected.Results There was no significant difference in stent placement between the two groups(P>0.05).There was no significant difference in the probability of grade 3 TIMI or TMPG between the two groups at 7 days after operation(P>0.05).The LAD CTFC,LCX CTFC and RCA CTFC were lower in the observation group than those in the control group and the LVESD and LVEDD were smaller than those of the control group,and LVEF was higher than that of the control group at

关 键 词：冠心病 三支病变 生脉注射液 心脏自主神经功能 心肌微循环 

分 类 号：R541.4[医药卫生—心血管疾病]