安心颗粒联合血栓抽吸对急诊冠脉介入术后心肌灌注影响的研究  

Influence of Anxin Particle together with Thrombus Aspiration on Myocardial Perfusion after Primary Percutaneous Coronary Intervention

作　　者：谭炜[1] 何贵新[1] 

机构地区：[1]广西中医药大学第一附属医院,广西南宁530023

出　　处：《南京中医药大学学报》2015年第1期13-16,共4页Journal of Nanjing University of Traditional Chinese Medicine

基　　金：广西省科学研究与技术开发计划课题(2011D39)

摘　　要：目的在接受急诊冠脉介入术(PCI)的急性ST段抬高型心肌梗死患者中,评价术前使用安心颗粒联合血栓抽吸术对心肌灌注的影响。方法 160例接受急诊冠脉介入术的急性ST段抬高型心肌梗死患者被随机分为安心颗粒组(术前顿服安心颗粒8.8g,术后安心颗粒4.4g/次,每日2次)和对照组。所有患者均服用阿司匹林、氯吡格雷和阿托伐他汀。术后观察心肌呈色分级(MBG)、心电图ST段回落百分比、肌钙蛋白(cTnI)和肌酸激酶同工酶(CK-MB)峰值、左室射血分数(LVEF)、主要不良心脏事件(MACE)。结果安心颗粒组术后的MBG分级较高(P<0.05),达到MBG 3级的患者比例较多(P<0.05),术后ST段回落百分比>70%的患者数较对照组多(P<0.05),cTnI(P<0.01)和CK-MB(P<0.05)峰值时间提前。术后第30天,安心颗粒组患者的左室射血分数明显高于对照组(P<0.01)。第(30±1)天时,2组患者主要不良心脏事件发生人数无显著性差别(P>0.05)。结论急诊冠脉介入术前使用安心颗粒,联合血栓抽吸术,能改善心肌灌注和泵功能,但对短期内主要不良心脏事件无影响。OBJECTIVE To evaluate the effect of Anxin particle together with thrombus aspiration on myocardial perfusion in patients with ST segment elevation myocardial infarction （STEMI） receiving primary percutaneous coronary intervention （PCI）. METHODS 160 STEMI patients receiving PPCI were randomly divided into two groups： Anxin group （AX） which had Anxin particle （8.8 g） administrated before PPCI twice a day and Anxin particle （4.4 g） after surgery twice a day and the control group （CN）. All the patients were given aspirin, clopidogrel, atorvastatin. After the surgery, Myocardial blush grade （MBG）, ST segment resolution, cardiac troponin I （cTnI） and creatine kinase-myocardial band （CK-MB） peak time, left ven- tricular eject fraction （LVEF）, and major adverse cardiac events （MACE） were compared between two groups. RESULTS MBG in AX group（P〈0.05） were higher than those of CN group and there were more patients who reached the third level of MBG（P〈0.05） and ST segment resolution〉70% （P〈0.05）. The peak time of cTnI（P〈0.01） and CK-MB（P〈0.05） was earlier in AX group than in CN group. On the 30th day after the surgery, LVEF in AX group was higher when compared with that of the CN group （P〈0.01）. MACE rates in both groups were similar on the day before or after the 30th day（P〉0.05）. CONCLUSION The present study indicated that pretreatment with Anxin particle before PPCI together with thrombus aspira- tion could improve myocardial perfusion and pump function but has no influence on short-term major adverse cardiac events.

关 键 词：安心颗粒 痰瘀同治 血栓抽吸 急诊冠脉介入术 急性心肌梗死 

分 类 号：R259.422[医药卫生—中西医结合]