山莨菪碱联合重组人脑利钠肽对急性前壁心梗患者PCI术后心功能及炎性因子的影响  

Effects of Anisodamine Combined with Recombinant Human Brain Natriuretic Peptide on Cardiac Function and Inflammatory Factors in Patients with Acute Anterior Wall Myocardial Infarction After PCI

作　　者：王绍伟[1] 郭会敏 安静霞 杨志家[1] 刘津军[1] 范卫泽[2] Wang Shaowei;Guo Huimin;An Jingxia(Handan Central Hospital of Hebei Province,Handan,Hebei 056008,China)

机构地区：[1]河北省邯郸市中心医院,河北邯郸056008 [2]河北医科大学第二医院,河北石家庄050000

出　　处：《四川医学》2021年第11期1117-1121,共5页Sichuan Medical Journal

摘　　要：目的探讨山莨菪碱联合重组人脑利钠肽(rhBNP)对急性前壁心肌梗死患者急诊经皮冠状动脉成形术(PCI)的有效性及安全性。方法选择2018年3月至2020年10月就诊我院急诊行PCI的患者62例,随机分为两组,对照组30例,试验组32例。对照组单纯行PCI治疗,试验组术前10 min给予rhBNP负荷剂量,术中冠脉内应用山莨菪碱,术后维持rhBNP静脉注射5 d。观察两组PCI术后心肌梗死溶栓试验(TIMI)血流分级、术后校正的TIMI血流计帧数(CTFC)、TIMI心肌灌注分级(TMPG),术后7 d血浆人脑利钠肽(NT-proBNP)、血清C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白介素6(IL-6)水平,术后1个月左心室舒张末期容积(LVEDV)、左心室射血分数(LVEF)。结果术后两组冠脉血流较术前均有改善,但较对照组,试验组TIMI血流3级及TMPG 3级水平有显著提高,CTFC明显好于对照组,差异有统计学意义(均P<0.05);术后7 d试验组NT-proBNP、CRP、TNF-α、IL-6均低于对照组,差异有统计学意义(均P<0.05),术后1个月LVEDV及LVEF改善情况均显著好于对照组,差异有统计学意义(均P<0.05)。结论山莨菪碱联合rhBNP可显著增加急性前壁心肌梗死术后心肌组织灌注,抑制炎性因子,改善心功能。Objective To explore the efficacy and safety of anisodamine combined with recombinant human brain natriuretic peptide(rhBNP)on patient with acute anterior myocardial infarction who received emergency percutaneous coronary intervention(PCI).Methods From March 2018 to October 2020,62 cases of patients with acute anterior myocardial infarction were randomly divided into 2 groups.Control group(CG,n=30)was treated with PCI only,while experimental group(EG,n=32)was given a loading dose of rhBNP at 10 minutes before operation,anisodamine was used in coronary artery during operation,and rhBNP was maintained intravenously for 5 days after PCI.Thrombolysis in Myocardial Infarction(TIMI)flow grade,postoperative corrected TIMI flow frame count(CTFC)and TIMI myocardial perfusion grade(TMPG)after PCI,NT-proBNP,serum C-reactive protein(CRP),tumor necrosis factor-α(TNF-α)and IL-6 at 7 days after PCI,left ventricular end diastolic volume(LVEDV)and left ventricular ejection fraction(LVEF)at 1 month after PCI were observed.Results TIMI flow grade was improved after PCI in both groups,but TIMI flow grade 3 and TMPG grade3 in EG were significantly higher(P<0.05),CTFC was significantly better than that in CG(P<0.05).NT-proBNP,CRP,TNF-αand IL-6 in EG were lower than those in CG at 7 days after PCI(P<0.05).At 1 month after PCI,improvements of LVEDV and LVEF in EG was significantly better than that in CG(P<0.05).Conclusion Anisodamine combined with rhBNP could significantly increase myocardial perfusion in patients with acute anterior myocardial infarction after PCI,inhibit inflammatory factors and improve cardiac function.

关 键 词：急性前壁心肌梗死 炎性因子 重组人脑利钠肽 山莨菪碱 心脏功能 

分 类 号：R542.22[医药卫生—心血管疾病]