血必凈注射液預(yù)防STEMI患者直接介入治療后冠脈無(wú)復(fù)流的效果

鄧偉

摘要：目的 ?探討血必凈注射液預(yù)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(wú)復(fù)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(duì)象，按照隨機(jī)數(shù)字表法分為觀察組和對(duì)照組，各41例。對(duì)照組給予常規(guī)西醫(yī)治療，觀察組在對(duì)照組基礎(chǔ)上加用血必凈注射液進(jìn)行治療，比較兩組PCI術(shù)后TIMI血流分級(jí)情況、尿微量白蛋白、肝腎功能及超敏C反應(yīng)蛋白水平。結(jié)果 ?兩組TIMI 0級(jí)、1級(jí)、2級(jí)占比比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）;觀察組TIMI 3級(jí)占比高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。兩組PCI術(shù)后24 h尿微量白蛋白陽(yáng)性占比比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）;觀察組術(shù)后尿微量白蛋白值低于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）;兩組PCI術(shù)后72 h肝腎功能比較，差異無(wú)統(tǒng)計(jì)學(xué)意義（P>0.05）。觀察組超敏C反應(yīng)蛋白水平為（4.54±2.10）mg/L，低于對(duì)照組的（5.83±2.68）mg/L，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論 ?STEMI患者應(yīng)用血必凈注射對(duì)預(yù)防急性心梗介入術(shù)后無(wú)復(fù)流及慢血流有一定作用，能減輕炎癥反應(yīng)，改善冠狀動(dòng)脈微循環(huán)的狀況，且對(duì)腎功能無(wú)明顯影響。

關(guān)鍵詞：急性ST段抬高型心肌梗死;介入治療;無(wú)復(fù)流;血必凈

中圖分類(lèi)號(hào)：R541.4 ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?文獻(xiàn)標(biāo)識(shí)碼：A ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ? ?DOI：10.3969/j.issn.1006-1959.2020.17.049

文章編號(hào)：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(jiàn)的急危重癥，是在冠狀動(dòng)脈粥樣硬化的基礎(chǔ)上發(fā)生斑塊破裂、血栓，造成冠狀動(dòng)脈中的造血功能急劇減少，甚至發(fā)生中斷，相應(yīng)的心肌位置出現(xiàn)非常嚴(yán)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(xù)時(shí)間超過(guò)20 min，血清心肌壞死標(biāo)志物濃度升高并存在動(dòng)態(tài)演變，通過(guò)心電圖檢查發(fā)現(xiàn)存在典型ST段抬高的急性心肌梗死，臨床表現(xiàn)包括發(fā)病數(shù)日前乏力、胸部嚴(yán)重不適，在活動(dòng)過(guò)程中存在心悸、煩躁以及心絞痛的情況，同時(shí)心絞痛較以前更加劇烈，持續(xù)時(shí)間延長(zhǎng)，且誘發(fā)疾病的原因不明確[1，2]。目前……