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医学临床研究  2021, Vol. 38 Issue (2): 233-236    DOI: 10.3969/j.issn.1671-7171.2021.02.021
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灯盏花素注射液联合比伐芦定对急性心肌梗死患者PCI术后心电图指标及心功能的影响
董志华1, 张川海2, 赵赫1
1.辽阳市中心医院心内科,辽宁 辽阳 111000;
2.锦州医科大学附属第一医院心内科,辽宁 锦州 121001
Effects of Breviscapine Injection Combined with Bivalrudin on the Electrocardiogram and serum H-FABP, IMA and TnT levels in patients with AMI after Intervention
DONG Zhi-hua, ZHANG Chuan-hai, ZHAO He
Liaoyang City Central Hospital, Liaoyang 111000
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摘要 【目的】 探讨灯盏花素注射液联合比伐芦定对急性心肌梗死(AMI)患者介入术后心电图指标及心功能的影响。【方法】 前瞻性选择2018年2月至2020年4月辽阳市中心医院收治的行PCI术治疗的116例AMI患者为研究对象,采用随机数表法将其分为观察组和对照组,每组各58例。对照组在常规治疗基础上给予比伐芦定治疗,观察组在对照组的基础上给予灯盏花素注射液治疗。比较两组患者治疗后心肌梗死溶栓(TIMI)血流分级、心功能指标[左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)]、血清指标[白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血清心脏型脂肪酸结合蛋白(H-FABP)、缺血修饰白蛋白(IMA)、肌钙蛋白T(cTnT)水平]及心电图情况[体表心电图QT离散度(QTd)、ST段回落]。治疗后随访3个月,记录两组患者主要不良心血管事件(MACE)发生情况。【结果】 治疗后,两组患者TIMI血流分级较治疗前改善,且观察组优于对照组,差异有统计学意义(P<0.05);两组患者LVEF水平高于治疗前,LVESD、LVEDD水平低于治疗前,且观察组与对照组存在差异,差异均有统计学意义(均P<0.05)。两组患者血清H-FABP、IMA、cTnT、IL-6、TNF-α水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组患者QTd均低于治疗前,且观察组低于对照组(P<0.05);观察组ST段回落良好率高于对照组(P<0.05)。治疗后3个月随访,观察组、对照组各脱落1例,观察组MACE发生率为7.02%(4/57),低于对照组的21.05%(12/57),差异有统计学意义(χ2=4.653,P=0.031<0.05)。【结论】 灯盏花素注射液联合比伐芦定治疗可改善AMI患者PCI术后心肌灌注、心电图情况及心功能,减轻机体炎症反应,降低血清H-FABP、IMA、TnT水平,减轻心肌损伤,降低MACE发生率,对改善患者预后具有重要意义。
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董志华
张川海
赵赫
关键词 心肌梗死/治疗急性病心电描记术脂肪酸结合蛋白质类/血液受体活性修饰蛋白质类/血液肌钙蛋白T/血液    
Abstract【Objective】 To investigate the effects of breviscapine injection combined with bivalrudin on the electrocardiogram and serum cardiac fatty acid binding protein (H-FABP), ischemia modifying albumin(IMA) and troponin T (TnT) levels in patients with acute myocardial infarction (AMI) after intervention. 【Methods】 A total of 116 AMI patients undergoing PCI surgery admitted to our hospital from February 2018 to April 2020 were selected as the research objects. They were divided into observation group (n=58) and control group (n=58) by simple randomization method. On the basis of conventional treatment, the control group was given bivalrudine, and the observation group was given breviscapine injection combined with bivalrudine. The TIMI blood flow classification, cardiac function indexes (LVEF, LVESD, LVEDD), serum indexes (IL-6, TNF-α, H-FABP, IMA, cTnT) and electrocardiogram (QT dispersion of surface electrocardiogram (QTd), ST segment depression) were compared between the two groups after treatment. The patients were followed up for 3 months after treatment, and the major adverse cardiovascular events (MACE) of the two groups were recorded. 【Results】 After treatment, TIMI blood flow classification of the two groups was improved, and the observation group was better than the control group, the difference was statistically significant (P<0.05); LVEF level of the two groups was higher than that before treatment, LVESD and LVEDD levels were lower than that before treatment, and there were differences between the observation group and the control group, the differences were statistically significant (all P<0.05). The serum levels of H-FABP, IMA, cTnT, IL-6 and TNF-αin the two groups were lower than those before treatment, and those in the observation group were lower than those in the control group (P<0.05). QTd of the two groups were lower than before treatment, and the observation group was lower than the control group (P<0.05); the good rate of ST segment depression of the observation group was higher than that of the control group (P<0.05). After 3 months of follow-up, the observation group and the control group had 1 case of shedding. The incidence of MACE in the observation group was 7.02% (4/57), which was lower than 21.05% (12/57) in the control group, and the difference was statistically significant (χ 2=4.653,P=0.031<0.05).【Conclusion】 Breviscapine injection combined with bivalirudin can improve myocardial perfusion, electrocardiogram and cardiac function, reduce inflammatory reaction, serum H-FABP, IMA and TnT levels, reduce myocardial injury and reduce the incidence of MACE in patients with AMI after PCI, which is of great significance to improve the prognosis of patients.
Key wordsMyocardial Infarction/TH    Acute Disease    Electrocardiography    Fatty Acid-Binding Proteins/BL    Receptor Activity-Modifying Proteins/BL    Troponin T/BL
收稿日期: 2020-10-28     
中图分类号:  R542.22  
引用本文:   
董志华, 张川海, 赵赫. 灯盏花素注射液联合比伐芦定对急性心肌梗死患者PCI术后心电图指标及心功能的影响[J]. 医学临床研究, 2021, 38(2): 233-236.
DONG Zhi-hua, ZHANG Chuan-hai, ZHAO He. Effects of Breviscapine Injection Combined with Bivalrudin on the Electrocardiogram and serum H-FABP, IMA and TnT levels in patients with AMI after Intervention. JOURNAL OF CLINICAL RESEARCH, 2021, 38(2): 233-236.
链接本文:  
http://journal07.magtech.org.cn/yxlcyj/CN/10.3969/j.issn.1671-7171.2021.02.021     或     http://journal07.magtech.org.cn/yxlcyj/CN/Y2021/V38/I2/233
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