合贝爽对ACS患者PCI中无复流、心功能以及炎性因子的影响

摘要

目的：探讨急性冠脉综合征（ACS）患者在经皮冠状动脉介入治疗（PCI）术中应用合贝爽对患者心功能、无复流现象及血清细胞因子水平的影响。方法选取建始县中医院心血管内科2012年1月～2015年2月实施PCI手术治疗出现无复流现象的150例ACS患者进行随机分组，合贝爽组75例给予合贝爽，常规组75例给予硝酸甘油，对比两组患者给药前后不同时间的无复流现象、心功能及血清细胞因子的改善情况。结果给药前合贝爽组和常规组的急性心肌梗塞溶栓治疗（TIMI）分级、校正的TIMI帧数（CTFC）差异无统计学意义（P＞0.05）；给药10 min、20 min后，合贝爽组的TIMI分级显著高于常规组（P＜0.05），合贝爽组的CTFC帧数显著低于常规组（P＜0.05）；术后1周，合贝爽组的左室射血分数显著高于常规组、舒张末期容积指数、收缩末期容积指数值显著的低于常规组（P＜0.05）；术后1周，合贝爽组的血清C反应蛋白、白细胞介素-6、肿瘤坏死因子-α、P选择素显著低于常规组（P＜0.05）；合贝爽组和常规组的术后12个月随访，两组的预后及并发症情况比较差异无统计学意义（P＞0.05）。结论 ACS患者在PCI术中应用合贝爽有利于改善患者的心功能、降低炎症反应、减少无复流现象。%Objective To investigate the influence of Herbesser Capsules on heart function, no-reflow phenomenon and serum cytokine level in in patients with acute coronary syndrome (ACS) during percutaneous coronary intervention (PCI).Methods ACS patients (n=150) with no-reflow phenomenon after PCI were chosen from the Department of Cardiology of Chinese Medicine Hospital in Jianshi County from Jan. 2012 to Feb. 2015, and randomly divided into Herbesser Capsules group treated with Herbesser Capsules and routine group treated with nitroglycerin (eachn=75). The changes of no-reflow phenomenon, heart function and serum cytokines level were observed in 2 groups at different time points before and after treatment.Results The differences in of thrombolysis in myocardial infarction (TIMI) grade and corrected TIMI frame count (CTFC) had no statistical significance between 2 groups before treatment (P>0.05). After treatment for 10 min and 20 min, TIMI grade were significantly higher (P<0.05) and CTFC was significantly lower in Herbesser Capsules group than those in routine group (P<0.05). After treatment for 1 w, left ventricular ejection fraction (LVEF) was significantly higher, and left ventricular end-diastolic volume index (LVEDVI) and left ventricular end-systolic volume index (LVESVI) were significantly lower in Herbesser Capsules group than those in routine group (P<0.05). The levels of C-reactive protein (hs-CRP), interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and P-selectin were significantly lower in Herbesser Capsules group than those in routine group after PCI for 1 w (P<0.05). The differences in prognosis and complication incidence had no statistical significance between 2 groups (P>0.05) during 12-month follow-up period after PCI.Conclusion The administration of Herbesser Capsules can improve heart function, relieve inflammatory reactions and reduce no-reflow phenomenon in ACS patients during PCI.