围术期丹参酮ⅡA磺酸钠注射液联合左西孟旦对急性心肌梗死并发心源性休克患者PCI后心功能、血液流变学指标的影响  

Effects of perioperative tanshinoneⅡA sodium sulfonate injection combined with levosimendan on cardiac function and hemorheology indexes after PCI in patients with acute myocardial infarction complicating cardiogenic shock

作　　者：杨红英[1] YANG Hongying(Department of Cardiology,Daxing District People′s Hospital,Beijing 102600,China)

机构地区：[1]北京市大兴区人民医院心内科,北京102600

出　　处：《检验医学与临床》2025年第9期1277-1281,1284,共6页Laboratory Medicine and Clinic

基　　金：北京市医院管理中心临床医学发展专项基金(XMLX212128)。

摘　　要：目的评价围术期丹参酮ⅡA磺酸钠注射液联合左西孟旦对急性心肌梗死(AMI)并发心源性休克(CS)患者经皮冠状动脉介入治疗(PCI)后心功能、血液流变学、炎症指标的影响。方法选择2022年1月至2023年12月该院收治的需行PCI的80例AMI并发CS患者作为研究对象,采用随机数字表法将患者分为对照组和观察组,每组40例。对照组在PCI围术期给予常规治疗,包括抗凝、抗血小板聚集,以及针对高糖、高血压、高血脂的降糖、降压、降脂及吸氧等对症支持治疗;观察组PCI围术期在对照组基础上给予丹参酮ⅡA磺酸钠注射液联合左西孟旦治疗。比较对照组和观察组治疗前后心功能、血液流变学指标变化。结果治疗后观察组和对照组左心室射血分数(LVEF)、左心室短轴缩短率(FS)均高于治疗前,左心室舒张末期内径(LVEDD)、左心室舒张末容量(LVEDV)均低于治疗前,差异均有统计学意义(P<0.05)。治疗后观察组LEVF、FS均高于对照组,LVEDD、LVEDV均低于对照组,差异均有统计学意义(P<0.05)。治疗后对照组和观察组全血高切黏度、全血低切黏度、血浆黏度、血细胞比容、红细胞聚集指数及纤维蛋白原(FIB)水平均低于治疗前,差异均有统计学意义(P<0.05)。治疗后观察组全血高切黏度、全血低切黏度、血浆黏度、血细胞比容、红细胞聚集指数及FIB水平均低于对照组,差异均有统计学意义(P<0.05)。治疗后对照组和观察组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、C-反应蛋白(CRP)水平均高于治疗前,差异均有统计学意义(P<0.05)。治疗后观察组IL-6、TNF-α、CRP水平均低于对照组,差异均有统计学意义(P<0.05)。观察组患者PCI后30 d主要主要不良心血管事件(MACE)发生率为12.50%,低于对照组的27.50%,差异有统计学意义(P<0.05)。结论围术期丹参酮IIA磺酸钠注射液联合左西孟旦治疗可进一步抑制AMI并发CS患者PCI后心室重构Objective To evaluate the effects of tanshinoneⅡA sodium sulfonate injection combined with levosimendan during the perioperative period on the cardiac function,hemorheology and inflammatory markers after percutaneous coronary intervention(PCI)in the patients with acute myocardial infarction(AMI)complicating cardiogenic shock(CS).Methods A total of 80 AMI patients with complicating CS undergoing PCI in this hospital from January 2022 to December 2023 were selected as the research subjects.The patients were divided into the control group and observation group by the random number table method,40 cases in each group.The control group was given the conventional treatment during the perioperative period of PCI,including anticoagulation,antiplatelet aggregation,and symptomatic supportive treatment such as hypoglycemic,antihypertensive,lipid-lowering and oxygen inhalation for hyperglycemia,hypertension and hyperlipidemia.The observation group was given tanshinoneⅡA sodium sulfonate injection combined with levosimendan on the basis of the control group during the perioperative period of PCI.The changes of cardiac function and hemorheology indexes before and after treatment were compared between the control group and observation group.Results After treatment,left ventricular ejection fraction(LVEF)and left ventricular short axis shortening rate(FS)in observation and control groups were higher than before treatment,and left ventricular end-diastolic diameter(LVEDD)and left ventricular end-diastolic volume(LVEDV)were lower than before treatment,the differences were statistically significant(P<0.05).After treatment,LVEF and FS in observation group were higher than control group,and LVEDD and LVEDV were lower than control group,the differences were statistically significant(P<0.05).After treatment,the whole blood high shear viscosity,whole blood low shear viscosity,plasma viscosity,hematocrit,erythrocyte aggregation index and fibrinogen(FIB)level in the control group and observation group were lower than those before trea

关 键 词：丹参酮ⅡA磺酸钠注射液 左西孟旦 急性心肌梗死 心源性休克 经皮冠状动脉介入治疗 心功能 血液流变学 

分 类 号：R541.6[医药卫生—心血管疾病] R446.11[医药卫生—内科学]