摘要：
Objective To investigate the effects of hyperbaric oxygen (HBO) combined with sodium tanshinone ⅡA sulfonate on inflammatory factors and cardiac function in patients with acute myocardial infarction (AMI) after thrombolysis.Methods Eighty-eight AMI patients admitted to the Department of Cardiology,Longkou People's Hospital from October 2015 to October 2018 were recruited as research subjects and all conformed to the diagnostic criteria of AMI.The patients were randomly divided into the observation group and the control group,each consisting of 44 patients.The control group was treated with sodium tanshinone Ⅱ A sulfonate on the basis of routine treatment of AMI,while the observation group was treated with HBO in addition to the treatment received by the control group.Both before treatment and 4 and 8 courses of treatment,close observations were made on serum inflammatory factors,i.e.the levels of:high-sensitivity C-reactive protein (hs-CRP),tumor necrosis factor-or (TNF-αt) and interleukin-6 (IL-6);on cardiac function:i.e.the levels of left ventricular ejection fraction (LVEF),left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV);on left ventricular remodeling indicators:i.e.left ventricular posterior wall thickness (LVPWT),end-diastolic septal thickness (IVST) and left ventricular myocardial mass index (LVMI).Results After 4 or 8 courses of treatment,the levels of IL-6,TNF-α and hs-CRP in the 2 groups were significantly lowered as compared with those before treatment (P ＜ 0.01),and there was statistical significance when comparisons were made between them (P ＜ 0.01).There was also statistical significance when comparisons were made between the observation group and the control group (P ＜ 0.05).After 8 courses of treatment,the LVEF levels of the 2 groups obviously elevated as compared with those before treatment,while the levels of LVESV and LVEDV significantly lowered,and statistical significance could be found when comparisons were made between them (P ＜ 0.01).There was also statistical significance,as compared with those of the control group after treatment (P ＜ 0.05).After 8 courses of treatment,the levels of LVMI in the patients of the 2 groups all elevated significantly,as compared with those before treatment,while the levels of IVST and LVPWT all considerably decreased in both groups,as compared with those before treatment,also with statistical significance (P ＜0.01).However,there was also statistical significance as compared with those of the control group after treatment (P ＜ 0.05).Conclusion HBO combined with sodium tanshinone ⅡA suifonate seemed to have high application value in the treatment of AMI.It could decrease the expression level of serum inflammatory factors,improve cardiac function and inhibit left ventricular remodeling.For this reason,it is worth further clinical application.%目的 探讨高压氧(HBO)联合丹参酮ⅡA磺酸钠治疗对急性心肌梗死(AMI)患者溶栓后炎性因子和心功能的影响.方法 选取龙口市人民医院心内科2015年10月至2018年10月收治的88例AMI患者,均符合AMI诊断标准.采用随机数字表法将88例患者分为观察组治疗和对照组,每组44例.对照组在AMI常规治疗基础上加用丹参酮ⅡA磺酸钠,观察组在对照组的基础上加用HBO治疗.分别在治疗前和治疗4、8个疗程后观察患者如下指标:(1)血清炎性因子:超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平;(2)心功能指数:左心室射血分数(LVEF)、左室收缩期末容积(LVESV)、左室舒张期末容积(LVEDV);(3)左心室重塑指标:左室后壁厚度(LVPWT)、舒张末期室间隔厚度(IVST)、左室心肌重量指数(LVMI).结果 治疗4、8个疗程后,2组患者与治疗前比较,IL-6、TNF-a和hs-CRP水平均明显降低,差异有统计学意义(P＜0.01),观察组与对照组治疗后比较,差异有统计学意义(P＜0.05).治疗8个疗程后,2组患者与治疗前比较,LVEF明显升高,LVESV和LVEDV均明显降低,差异有统计学意义(P＜0.01);与对照组治疗后比较,差异有统计学意义(P＜0.05).治疗8个疗程后,2组患者与治疗前比较,LVMI明显升高,IVST和LVPWT均明显降低,差异有统计学意义(P＜0.01);与对照组治疗后比较,差异有统计学意义(P＜0.05).结论 HBO联合丹参酮ⅡA磺酸钠治疗AMI具有较高的应用价值,能够减轻患者血清炎性因子的表达水平、改善患者的心功能、抑制左心室重塑,值得临床进一步推广应用.
