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目的:探讨丹参滴丸联合强化降脂治疗对急性心肌梗死PCI术后再梗死的预防作用。方法:选取医院自2014年4月—2014年11月确诊的急性ST段抬高型心肌梗死行PCI术患者104例,根据随机数字表法进行分组,对照组52例予以术后予以常规降脂治疗,控制原发病等常规治疗,研究组52例在常规治疗上予以丹参滴丸(10丸/次,tid)联合强化降脂(阿托伐他汀钙片80 mg/d,qd)治疗,3个月为1疗程。用药前、介入后24 h及介入后7 d采血测定血清细胞因子、心肌损伤标志物及血管内皮功能指标,对比两组间心肌微循环灌注状况,进行2年的随访,观察并记录心血管事件。结果:经单因素方差分析,与用药前比较,两组用药不同时间点血清细胞因子、心肌损伤及血管内皮功能指标存在差异(P<0.05);与对照组比较,研究组介入后24 h、介入后7 d时血清CRP、TNF-α、IFN-γ、IL-6含量较低,血清CK-MB、c Tn I、BNP含量较低,血清ET、s ICAM-1含量较低,NO含量较高(P<0.05);研究组用药后心肌微循环灌注改善程度更高(P<0.05);随访2年期间无病例脱落现象,两组间心血管事件对比,无差异(P>0.05)。结论:丹参滴丸联合强化降脂治疗对急性心肌梗死PCI术后心肌保护作用较强,抑制手术导致的炎症反应及血管内皮损伤,改善心肌微循环灌注。
Objective: To investigate the preventive effect of Danshen dripping pills combined with intensive lipid-lowering therapy on reinfarction after PCI in patients with acute myocardial infarction. Methods: A total of 104 patients with acute ST-segment elevation myocardial infarction who were diagnosed from April 2014 to November 2014 in our hospital were selected and randomly divided into two groups according to the random number table. The control group was given routine lipid-lowering 52 cases of the study group were treated with Danshen dripping pills (10 pills / time, tid) combined with intensive lipid-lowering (atorvastatin calcium 80 mg / d, qd) on routine treatment, 3 months for a course of treatment. Serum cytokines, myocardial injury markers and vascular endothelial function were measured before and 24 h after intervention and 7 d after intervention. The myocardial microcirculation perfusion was compared between the two groups and followed up for 2 years. Cardiovascular events were observed and recorded . Results: Compared with the control group, the levels of serum cytokines, myocardial injury and vascular endothelial function in the two groups were significantly different at different time points after administration (P <0.05). Compared with the control group, Serum levels of CRP, TNF-α, IFN-γ and IL-6 were lower at 7 d after intervention, with lower levels of serum CK-MB, cTn I and BNP, lower levels of serum ET and s ICAM- (P <0.05). There was no significant difference between the two groups in the rate of cardiovascular events (P> 0.05) . Conclusion: Danshen Dripping Pill combined with intensive lipid-lowering therapy has a strong protective effect on myocardial infarction after PCI, which can inhibit the inflammation reaction and vascular endothelial injury caused by surgery, and improve myocardial microcirculation perfusion.