目的:探讨丹红注射液对急性心肌梗死(acute myocardial infarction,AMI)患者经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)后血清IL-6和IL-17水平的影响.方法:选取2014年6月至2016年1月在第四军医大学唐都医院心内科急诊PCI术后的120例ST抬高型心肌梗死(ST-elevation myocardial infarction,STEMI)患者,随机分为对照组和研究组,每组各60例.两组均给予常规治疗,而研究组则在常规治疗基础上给予静脉滴注丹红注射液治疗.观察两组临床症状和体征的改善情况、心电图的恢复情况及不良反应发生情况,评估两组的临床疗效.ELISA测定两组患者治疗前和治疗3,7 d后血清IL-6和IL-17的水平.比较两组治疗前后左室射血分数和心肌梗死面积的变化.随访6个月,观察两组患者主要不良心血管事件(major adverse cardiovascular events,MACE)的发生情况.结果:研究组治疗的总有效率为90.00%,显著高于对照组的76.67%,两组间差异有统计学意义(P<0.05);研究组治疗3,7 d后血清IL-6水平分别为(56.38±10.75)ng/mL,(42.52±8.14)ng/mL,均显著低于对照组的(62.73±12.08)ng/mL,(51.65±9.78)ng/mL,两组间差异有统计学意义(P<0.05);研究组治疗3,7 d后血清IL-17水平分别为(28.73±5.68)ng/mL,(22.54±4.55)ng/mL,均显著低于对照组的(34.39±6.21)ng/mL和(29.82±5.74)ng/mL,两组间差异有统计学意义(P<0.05);研究组治疗后的LVEF为54.72%±5.64%,显著高于对照组的49.38%±4.57%,两组间差异有统计学意义(P<0.05);研究组治疗后的心肌梗死面积为10.64%±4.38%,明显低于对照组的16.74%±5.49%,两组间差异有统计学意义(P<0.05);研究组的MACE发生率为5.00%,显著低于对照组的16.67%,两组间差异有统计学意义(P<0.05).结论:丹红注射液可有效降低PCI术后STEMI患者血清L-6和IL-17的水平,改善患者心功能,缩小心肌梗死面积,降低MACE的发生率,安全有效,值得应用于临床.%Objective: To discuss the impact of Danhong injection on the serum IL-6 and IL-17 level in patients with acute myocardial infarction after percutaneous coronary intervention (PCI). Methods: A total of 120 patients with STsegment elevation myocardial infarction (STEMI) after PCI from June 2014 to January 2016 were selected and randomly divided into a control group and a research group, with 60 patients in each. All patients were treated with conventional treatments, while the research group were treated with Danhong injection on the basic of the control group. The improvements of clinical symptoms, electrocardiogram and adverse reactions were observed,the levels of IL-6 and IL-17 before and after treatment for 3, 7 d were detected, and the left ventricular ejection fraction (LVEF) and myocardial infarction area in the two groups were compared. The patients were followedup for 6 months, in which the occurrence of the major adverse cardiovascular events (MACE) were observed.Results: The total effective rate was 90.00% in the research group, which was higher than that in the control group (76.67%), the difference was statistically significant (P<0.05). The levels of IL-6 were (56.38±10.75) ng/mL and (42.52±8.14) ng/mL in the research group after treatments for 3 and 7 d, which were lower than that in the control group [(62.73±12.08) ng/mL and (51.65±9.78) ng/mL], differences were statistically significant (P<0.05). The levels of IL-17 were (28.73±5.68) ng/mL and (22.54±4.55) ng/mL in the research group after treatment for 3 and 7 d, which were lower than that in control group [(34.39±6.21) ng/mL and (29.82±5.74) ng/mL], the difference was statistically significant (P<0.05). The LVEF was 54.72%±5.64% in the research group after treatment, which was higher than that in the control group (49.38%±4.57%), the difference was statistically significant (P<0.05).The myocardial infarction area was 10.64%±4.38% in the research group after treatments for 3 and 7 d, which was lower than that in the control group (16.74%±5.49%), the difference was statistically significant (P<0.05). The occurrence rate of MACE was 5.00%, while that in the control group was 16.67%, the difference was statistically significant (P<0.05). Conclusion: Patients with acute myocardial infarction after PCI in treatments of Danhong injection can reduce the levels of IL-6 and IL-17, improve cardiac function, reduce the myocardial infarction area,and lower the occurrence rate of MACE, which is worthy of clinical use.
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