| 王学杰,王自豪,原建华.麝香保心丸联合双抗对急性心肌梗死经皮冠脉介入术后心肌灌注及心功能转归的影响[J].安徽医药,2025,29(2):400-405. |
| 麝香保心丸联合双抗对急性心肌梗死经皮冠脉介入术后心肌灌注及心功能转归的影响 |
| Effect of Shexiang Baoxin pill combined with dual antibody therapy on myocardial perfusion and cardiac function outcome after PCI in acute myocardial infarction patients |
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| DOI：10.3969/j.issn.1009-6469.2025.02.039 |
| 中文关键词: 心肌梗死 麝香保心丸 经皮冠脉介入术 心肌灌注 心功能 |
| 英文关键词: Myocardial infarction Shexiangbaoxin pills Percutaneous coronary intervention Myocardial perfusion Cardiac function |
| 基金项目:河南省医学科技攻关计划联合共建项目( LHGJ20191298) |
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| 中文摘要: |
| 目的探讨麝香保心丸联合双抗对急性心肌梗死经皮冠脉介入( PCI)术后心肌灌注的治疗效果及对心功能转归的影响。方法选取 2019年 1月至 2020年 1月鹤壁市人民医院心内科收治的 180例急性心肌梗死 PCI术病人，按随机数字表法分为双抗组、联合组，每组各 90例。双抗组口服阿司匹林、氯吡格雷，联合组在双抗组基础上加服麝香保心丸。观察两组病人的临床疗效，经心脏影像学检查比较其术后心肌灌注指标差异，参考 Killip分级评估病人治疗后心功能转归结果，检测病人治疗前后生长分化因子 -15(GDF-15)、超敏 C反应蛋白( hs-CRP)和血清肌钙蛋白( CTNI)变化，统计其住院期间主要心血管事件发生率。结果治疗后，联合组治疗总有效率( 84.44%)高于双抗组( 66.67%)(P<0.05)。治疗后，联合组心肌梗死溶栓试验( TI-MI)3级血流病人占比( 91.11%)高于双抗组( 78.89%)；与治疗前比较，联合组和双抗组治疗后的校正 TIMI帧计数( CTFC)［( 15.39±2.21)帧比( 29.65±1.36)帧，(20.65±2.75)帧比( 29.25±1.47)帧］均降低( P<0.05)且联合组更低( P<0.05)。两组治疗后的心功能 Killip分级优于治疗前(P<0.05)，但组间比较差异无统计学意义( P>0.05)。与治，疗前比较，联合组和双抗组治疗后的 GDF-15［( 62.41±5.31)pg/L比( 311.65±39.93)pg/L，(89.69±6.35)pg/L比( 311.75±39.78)pg/L］、 hs-CRP［( 12.60±1.17)mg/L比(29.37±2.46)mg/L，(16.77±1.15)mg/L比( 29.18±2.28)mg/L］、 CTNI［( 0.05±0.01)μg/L比( 2.51±0.53)μg/L，(0.12±0.01)μg/L比(2.64±0.58)μg/L］均降低( P<0.05)且联合组更低( P<0.05)。联合组病人住院期间主要心血管事件发生率( 12.22%)低于双抗组( 25.56%)(P<0.05)。两组不良比较( 2.22%比 1.11%)对比，差异无统计学意义( P>0.05)。结论麝香保心丸联合双抗反应，对急性心肌梗死病人 PCI术后心肌灌注障碍有明显的治疗优势，还可促使心功能转归，改善临床预后。 |
| 英文摘要: |
| Objective To explore the therapeutic effect of Shexiang Baoxin pill combined with dual antibody therapy on myocardialperfusion after percutaneous coronary intervention (PCI) in acute myocardial infarction patients and its effect on cardiac function out‐come.Methods A total of 180 patients with acute myocardial infarction undergoing PCI in the Department of Cardiology of Hebi Peo-ple's Hospital from January 2019 to January 2020 were randomly assigned into dual antibody group and combination group, with 90cases in each group. Aspirin and clopidogrel were taken orally in the dual antibody group, and Shexiang Baoxin pill was given addition-ally to the combination group on the basis of the dual antibody therapy. The clinical efficacies of the two groups were observed, and thedifferences in postoperative myocardial perfusion indexes were compared by cardiac imaging examination. The outcome of cardiac func-tion after treatment was evaluated with reference to Killip grading, and the changes of growth differentiation factor-15 (GDF-15), hyper-sensitive C reactive protein (hs-CRP) and cardiac troponin (CTNI) were measured before and after treatment, and the incidence of majorcardiovascular events during hospitalization was counted. Results After treatment, the total effective rate of the combination group(84.44%) was higher than that of the dual antibody group (66.67%) (P<0.05). After treatment, the proportion of patients with grade 3blood flow in the thrombolysis in myocardial infarction (TIMI) test in the combination group (91.11%) was higher than that in the dualantibody group (78.89%).Compared with the corrected TIMI frame count (CTFC) before treatment, CTFCs after treatment in both thecombination group and the dual antibody group decreased [(15.39±2.21) frames vs. (29.65±1.36) frames, (20.65±2.75) frames vs. (29.25±1.47) frames; P<0.05] and that in the combination group was even lower (P<0.05). The Killip classification for heart function in the two groups of patients after treatment was better than that before treatment (P<0.05), but there was no statistically significant differ-ence between the groups (P>0.05). Compared with before treatment, the expressions of GDF-15 [(62.41±5.31) pg/L vs. (311.65±39.93) pg/L, (89.69±6.35) pg/L vs. (311.75±39.78) pg/L], hs-CRP [(12.60±1.17) mg/L vs. (29.37±2.46) mg/L, (16.77±1.15) mg/L vs. (29.18± 2.28) mg/L], and CTNI [(0.05±0.01) μg/L vs. (2.51±0.53) μg/L, (0.12±0.01) μg/L vs. (2.64±0.58) μg/L] in both the combination group and dual antibody group were reduced after treatment (P<0.05), which were lower in the combination group (P<0.05). The incidence ofmajor cardiovascular events during hospitalization in the combination group (12.22%) was lower than that in the dual antibody group(25.56%)(P<0.05). The difference in adverse reactions between the two groups (2.22% vs. 1.11%) showed no statistical significance (P> 0.05).Conclusion Shexiang Baoxin pill combined with dual antibody therapy has obvious advantages in the treatment of myocardialperfusion disturbance after PCI in patients with acute myocardial infarction, and can also promote the outcome of cardiac function andimprove clinical prognosis. |
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