血必凈注射液預防STEMI患者直接介入治療后冠脈無復流的效果

鄧偉

摘要：目的 ?探討血必凈注射液預防急性ST段抬高型心肌梗死（STEMI）患者直接介入治療后冠脈無復流的效果。方法 ?選取2016年6月～2017年9月我院接受介入治療的STEMI患者82例作為研究對象，按照隨機數字表法分為觀察組和對照組，各41例。對照組給予常規西醫治療，觀察組在對照組基礎上加用血必凈注射液進行治療，比較兩組PCI術后TIMI血流分級情況、尿微量白蛋白、肝腎功能及超敏C反應蛋白水平。結果 ?兩組TIMI 0級、1級、2級占比比較，差異無統計學意義（P>0.05）;觀察組TIMI 3級占比高于對照組，差異有統計學意義（P<0.05）。兩組PCI術后24 h尿微量白蛋白陽性占比比較，差異無統計學意義（P>0.05）;觀察組術后尿微量白蛋白值低于對照組，差異有統計學意義（P<0.05）;兩組PCI術后72 h肝腎功能比較，差異無統計學意義（P>0.05）。觀察組超敏C反應蛋白水平為（4.54±2.10）mg/L，低于對照組的（5.83±2.68）mg/L，差異有統計學意義（P<0.05）。結論 ?STEMI患者應用血必凈注射對預防急性心梗介入術后無復流及慢血流有一定作用，能減輕炎癥反應，改善冠狀動脈微循環的狀況，且對腎功能無明顯影響。

關鍵詞：急性ST段抬高型心肌梗死;介入治療;無復流;血必凈

中圖分類號：R541.4 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?文獻標識碼：A ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?DOI：10.3969/j.issn.1006-1959.2020.17.049

文章編號：1006-1959（2020）17-0163-03

Abstract：Objective ?To investigate the effect of Xuebijing injection in preventing coronary artery no-reflow after direct interventional therapy in patients with acute ST-segment elevation myocardial infarction （STEMI）.Methods ?A total of 82 patients with STEMI who received interventional therapy in our hospital from June 2016 to September 2017 were selected as the research objects. According to the random number table method， they were divided into observation group and control group， with 41 cases in each group. The control group was treated with conventional western medicine， and the observation group was treated with Xuebijing injection on the basis of the control group. The TIMI blood flow classification， urine microalbumin， liver and kidney function， and hypersensitivity C-reactive protein were compared between the two groups after PCI Level.Results ?There was no significant difference in the proportion of TIMI grade 0， grade 1， and grade 2 between the two groups （P>0.05）; the proportion of TIMI grade 3 in the observation group was higher than that in the control group，the difference was statistically significant （P<0.05）. There was no statistically significant difference in the percentage of positive urine microalbumin in the two groups at 24 h after PCI （P>0.05）; the postoperative urine microalbumin value of the observation group was lower than that of the control group，the difference was statistically significant （P<0.05）; There was no significant difference in liver and kidney function 72 h after PCI between the two groups （P>0.05）. The level of hypersensitivity C-reactive protein in the observation group was （4.54±2.10） mg/L， which was lower than that of the control group （5.83±2.68） mg/L， the difference was statistically significant （P<0.05）.Conclusion ?Xuebijing injection in STEMI patients had a certain effect on preventing no reflow and slow blood flow after acute myocardial infarction. It could reduce inflammation， improve coronary microcirculation， and had no significant effect on renal function.

Key words：Acute ST-segment elevation myocardial infarction;Interventional therapy;No reflow; Xuebijing

急性心肌梗死（acute myocardial infarction）是臨床上常見的急危重癥，是在冠狀動脈粥樣硬化的基礎上發生斑塊破裂、血栓，造成冠狀動脈中的造血功能急劇減少，甚至發生中斷，相應的心肌位置出現非常嚴重的急性缺血，從而引起心肌的急性梗死。急性ST段抬高型心肌梗死（STEMI）是一種具有典型缺血性胸痛、持續時間超過20 min，血清心肌壞死標志物濃度升高并存在動態演變，通過心電圖檢查發現存在典型ST段抬高的急性心肌梗死，臨床表現包括發病數日前乏力、胸部嚴重不適，在活動過程中存在心悸、煩躁以及心絞痛的情況，同時心絞痛較以前更加劇烈，持續時間延長，且誘發疾病的原因不明確[1，2]。目前……