丹参川芎嗪联合替罗非班对急性ST段抬高型心肌梗死患者冠脉介入术后视黄醇结合蛋白4的影响

摘要

目的 探讨丹参川芎嗪联合半剂量替罗非班对急性ST段抬高型心肌梗死(STEMI)患者经皮冠脉介入治疗(PCI)术后血清视黄醇结合蛋白4(RBP4)水平及临床缺血事件的影响.方法 按分层随机化法将130例行PCI手术的STEMI患者,分为两组,对照组60例PCI术后常规治疗,观察组70例另给予半剂量替罗非班维持48 h联合丹参川芎嗪注射液治疗7 d.并统计术后相关指标(7d RBP4及肾小球滤过率、肌钙蛋白T)及术后半年的临床缺血事件(复合缺血及出血事件、冠脉TIMI血流).结果 术后7 d,观察组较对照组的RBP4、肌钙蛋白T(CTnT)平均值均有下降(P<0.05),肾小球滤过率(GFR)有升高(P<0.05);未增加半年的缺血与出血事件(P>0.05).结论 使用丹参川芎嗪联合半剂量替罗非班可降低STEMI患者PCI术后RBP4水平,改善患者肾功能及心肌的缺血坏死,且不增加出血风险.%Objective To investigate the effect of Salvia miltiorrhiza Ligustrazine combined with half dose tiro-fiban on the postoperative serum retinol binding protein 4(RBP4)level and clinical ischemic events in acute ST eleva-tion myocardial infarction(STEMI)patients who recevied percutaneous coronary intervention(PCI).Methods Strati-fied randomization method was adpoted to divede 130 cases underwent PCI STEMI into two groups,60 cases in the con-trol group after PCI treated with conventional treatment,70 cases in observation group were given the other half dose tiro-fiban treatment 48h combined with Salviae Miltiorrhizae and Ligustrazine Hydrochloride Injection 7d.The postoperative related indexes(7d,RBP4 and glomerular filtration rate,troponin T)and clinical ischemic events(ischemia and hemor-rhage events,coronary TIMI blood flow)were evaluated.Results The mean value of serum RBP4 and CTnT in the ob-servation group decreased and GFR increased compared with the control group on the 7 day after operation,Ischemic and hemorrhagic events did not show significant difference for half a year.Conclusion The use of Danshen Ligustrazine combined with half dose tirofiban in patients with PCI can reduce the level of RBP 4 in patients with STEMI,improve the renal function and myocardial ischemia without increasing the risk of bleeding.