回阳复脉汤辅助PCI术对心肾阳虚型急性心肌梗死患者TIMI血流分级、冠脉微循环及MACE的影响  

Effects of Huiyang Fumai Decoction-assisted percutaneous coronary intervention on thrombolysis in myocardial infarction blood flow grading,coronary microcirculation and major adverse cardiovascular events in patients with acute myocardial infarction of heart-kidney Yang deficiency type

作　　者：张威山 唐琨 朱伟勇 刘万霞 ZHANG Wei-shan;TANG Kun;ZHU Wei-yong;LIU Wan-xia(Department of Cardiology,Zhumadian Hospital of Traditional Chinese Medicine,Zhumadian 463000,Henan,CHINA;Department of Pharmacy,Zhumadian Hospital of Traditional Chinese Medicine,Zhumadian 463000,Henan,CHINA;Department of Geriatrics,Zhumadian Hospital of Traditional Chinese Medicine,Zhumadian 463000,Henan,CHINA)

机构地区：[1]驻马店市中医院心内科,河南驻马店463000 [2]驻马店市中医院药学科,河南驻马店463000 [3]驻马店市中医院老年病科,河南驻马店463000

出　　处：《海南医学》2024年第12期1699-1704,共6页Hainan Medical Journal

基　　金：2021年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20212394)。

摘　　要：目的探讨回阳复脉汤辅助经皮冠状动脉介入治疗(PCI)术对心肾阳虚型急性心肌梗死(AMI)患者心肌梗死溶栓试验(TIMI)血流分级、冠脉微循环及主要心血管不良事件(MACE)的影响。方法选取2021年3月至2023年3月驻马店市中医院收治的86例AMI患者进行前瞻性随机平行对照研究,按随机数表法分为PCI组和联合组各43例。PCI组患者予以PCI术,联合组患者予以回阳复脉汤辅助PCI术。比较两组患者PCI术后TIMI血流分级、冠脉血流储备(CFR)、微循环阻力指数(IMR)、TIMI心肌灌注帧数(TMPFC)、内皮素-1(ET-1)、一氧化氮(NO)、P选择素、中性粒细胞与淋巴细胞比值(NLR)、高敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、纤溶酶原激活物抑制物(PAI-1)、血小板α颗粒膜糖蛋白(CD62P)、安全性及MACE发生率。结果联合组患者的TIMI血流分级Ⅰ级0例,Ⅱ级0例,Ⅲ级43例,优于PCI组的Ⅰ级1例,Ⅱ级6例,Ⅲ级36例,差异有统计学意义(P<0.05);联合组患者PCI术后即刻CFR为2.94±0.28,明显高于PCI组的2.60±0.31,IMR、TMPFC分别为12.15±2.84、(92.00±3.24)帧,明显低于PCI组的14.77±3.56、(95.18±4.67)帧,差异均有统计学意义(P<0.05);联合组患者PCI术后即刻和术后5 d的ET-1分别为(132.41±19.67)ng/L、(113.02±14.76)ng/L,明显低于PCI组的(151.33±38.95)ng/L、(148.51±40.00)ng/L,NO分别为(62.43±13.55)μmol/L、(67.89±11.22)μmol/L,明显高于PCI组的(50.68±16.24)μmol/L、(52.03±15.49)μmol/L,差异均有统计学意义(P<0.05);联合组患者PCI术后即刻和术后5 d的P选择素、NLR、hs-CRP、IL-6水平均明显低于PCI组,差异均有统计学意义(P<0.05);联合组患者PCI术后即刻和术后5 d的PAI-1、CD62P分别为(9.33±1.20)μg/L、(8.08±1.33)μg/L;(45.37±5.38)%、(40.05±4.27)%,明显低于PCI组的(12.00±1.87)μg/L、(11.17±1.65)μg/L;(48.40±6.29)%、(45.59±5.31)%,差异均有统计学意义(P<0.05);联合组患者的MACE总发生率为2.38%,明显低于PCI组的18.60%,差异有�Objective To investigate the effect of Huiyang Fumai Decoctio-assisted percutaneous coronary intervention(PCI)on thrombolysis in myocardial infarction(TIMI)blood flow grading,coronary microcirculation,and major adverse cardiovascular events(MACE)in patients with acute myocardial infarction(AMI)of heart-kidney Yang deficiency type.Methods A prospective randomized parallel controlled study was conducted on 86 patients with AMI admitted to the Zhumadian Hospital of Traditional Chinese Medicine from March 2021 to March 2023.They were randomly divided into a PCI group and a combined group according to a random number table,with 43 patients in each group.The patients in the PCI group underwent PCI,while the patients in the combined group received Huiyang Fumai Decoction-assisted PCI.The TIMI flow classification,coronary flow reserve(CFR),index of microcirculation resistance(IMR),TIMI myocardial perfusion frame count(TMPFC),endothelin-1(ET-1),nitric oxide(NO),P-selectin,neutrophil-to-lymphocyte ratio(NLR),high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6),plasminogen activator inhibitor-1(PAI-1),platelet alpha-granule membrane glycoprotein(CD62P),safety,and MACE incidence after PCI were compared between the two groups.Results The TIMI blood flow grade of the patients in the combined group was 0 in gradeⅠ,0 in gradeⅡ,and 43 cases in gradeⅢ,which was better than 1 case in gradeⅠ,6 cases in gradeⅡ,and 36 cases in gradeⅢin the PCI group(P<0.05).The immediate CFR after PCI in the combined group was 2.94±0.28,which was significantly higher than 2.60±0.31 in the PCI group(P<0.05).The IMR and TMPFC were 12.15±2.84 and(92.00±3.24)frames,respectively,which were significantly lower than 14.77±3.56 and(95.18±4.67)frames in the PCI group(P<0.05).The ET-1 levels immediately after PCI and on day 5 after PCI in the combined group were(132.41±19.67)ng/L and(113.02±14.76)ng/L,respectively,which were significantly lower than(151.33±38.95)ng/L and(148.51±40.00)ng/L in the PCI group,and the NO levels were(

关 键 词：回阳复脉汤 经皮冠状动脉介入治疗 心肾阳虚型 急性心肌梗死 心肌梗死溶栓试验血流分级 冠脉微循环 主要心血管不良事件 

分 类 号：R542.22[医药卫生—心血管疾病]