止麻消痰活血方对低危非ST段抬高型急性冠状动脉综合征患者经皮冠状动脉介入术后无复流和预后的影响  

Effects of Zhima Xiaotan Huoxue Recipe on no-reflow and prognosis after percutaneous coronary intervention in low-risk non-ST-elevation acute coronary syndrome patients

作　　者：刘琪 贾运时 宋温婷 李武卫[1] LIU Qi;JIA Yunshi;SONG Wenting;LI Wuwei(Department of Cardiology,Shijiazhuang Hospital of Traditional Chinese Medicine of Hebei Province,Shijiazhuang,Hebei,050000)

机构地区：[1]河北省石家庄市中医院心内科,河北石家庄050000

出　　处：《实用临床医药杂志》2021年第24期69-73,共5页Journal of Clinical Medicine in Practice

基　　金：河北省中医药管理局科研计划项目(2019404)。

摘　　要：目的探讨止麻消痰活血方对低危非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者经皮冠状动脉介入术(PCI)后冠状动脉无复流和预后的影响及可能作用机制。方法选取72例拟择期行PCI的低危NSTE-ACS患者为研究对象,随机分为对照组和实验组。对照组36例给予西医常规治疗及护理,实验组在对照组基础上术前7 d口服止麻消痰活血方。比较2组术后心肌梗死血流分级(TIMI)、无复流现象发生率、TIMI心肌灌注(TMPG)血流分级、主要不良心脏事件(MACE)发生率,术后7、30 d左心室射血分数(LVEF)和B型利钠肽(NT-proBNP)、白细胞介素(IL)-2、IL-6、超敏C反应蛋白(hs-CRP)及血管内皮糖萼降解产物乙酰肝素、多配体蛋白聚糖-1(Syndecan-1)、透明质酸水平。结果干预后,实验组TIMI 3患者占比、TMPG 3患者占比、术后LVEF水平均高于对照组,差异有统计学意义(P<0.05);干预后,实验组患者术后无复流发生率、NT-proBNP、IL-2、IL-6、hs-CRP、血清硫酸乙酰肝素、Syndecan-1、透明质酸水平均低于对照组,差异有统计学意义(P<0.01)。结论止麻消痰活血方可有效防止低危NSTE-ACS PCI术后无复流现象,能够增加心肌血流灌注,降低MACE总发生率,抑制炎症反应,减轻血管内皮损伤,改善心功能及预后。Objective To explore effects of Zhima Xiaotan Huoxue Recipe on no-reflow and prognosis after percutaneous coronary intervention(PCI) in low-risk non-ST-elevation acute coronary syndrome(NSTE-ACS) patients and its possible action mechanism. Methods A total of 72 low-risk NSTE-ACS patients who underwent elective PCI were selected as objects and randomly divided into control group and experimental group. A total of 36 patients in the control group were given conventional treatment and nursing by western medicine, and the experimental group orally administrated Zhima Xiaotan Huoxue Decoction 7 days before the operation based on the control group. The blood flow grading(TIMI) after operation, the incidence of no-reflow phenomenon, blood flow grading of TIMI myocardial perfusion grade(TMPG), and incidence of major adverse cardiac events(MACE), left ventricular ejection fraction(LVEF) and N-terminal precursor B type natriuretic peptide(NT-proBNP) 7 days and 30 days after surgery, interleukin(IL)-2, IL-6, hypersensitive C-reactive protein(hs-CRP) and endothelial glycocalyx degradation products heparan, Syndecan-1, hyaluronic acid levels were compared. Results After the intervention, the proportions of patients with TIMI 3 and TMPG 3 and postoperative LVEF levels in the experimental group were higher than those in the control group( P < 0. 05);after intervention,the incidence of no-reflow,postoperative NT-proBNP,IL-2,IL-6,hs-CRP,serum heparan sulfate,Syndecan-1,and hyaluronic acid levels in the experimental group were lower than those of the control group( P < 0. 01). Conclusion Zhima Xiaotan Huoxue Decoction can effectively prevent the occurrence of no-reflow after the low-risk NSTE-ACS after PCI,increase myocardial blood perfusion,reduce the total incidence of MACE,inhibit inflammation,relieve vascular endothelial damage,and improve cardiac function and prognosis.

关 键 词：止麻消痰活血方 糖萼降解 低危 非ST段抬高型急性冠状动脉综合征 经皮冠状动脉介入术 无复流 

分 类 号：R543.3[医药卫生—心血管疾病] R61[医药卫生—内科学]