丹参川芎嗪注射液对不稳定型心绞痛患者冠脉介入术后心肌损伤的影响

作者	单位
王睿	山西医科大学第一医院心内科
吕吉元	山西医科大学第一医院心内科
贾永平	山西医科大学第一医院心内科
韩清华	山西医科大学第一医院心内科

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中文摘要:

目的观察丹参川芎嗪注射液对不稳定型心绞痛(unstable angina,UA)患者经皮冠状动脉介入术(percutaneous coronary intervention,PCI)治疗后心肌损伤的影响。方法将76例UA患者随机分为试验组(39例)和对照组(37例)。两组均给予西药常规治疗及PCI手术治疗,试验组在常规治疗基础上于PCI术前3～5天给予丹参川芎嗪注射液10mL加入250mL生理盐水中静脉滴注,每天1次,共7～10天。观察两组患者用药前后血小板P-选择素阳性表达的变化,PCI术后心肌梗死溶栓试验(thrombolysis in myocardial infarction,TIMI)心肌灌注(myocardial perfusion,TMP)分数及心肌损伤标志物肌酸激酶同工酶(CK-MB)和肌钙蛋白I(TnI)的水平。结果用药后试验组P-选择素阳性表达率[(2·45±1·42)%]低于同期对照组[(4·43±1·79)%],差异有统计学意义(P<0·05)。PCI术后试验组TMP0/1级的发生率及CK-MB、TnI水平低于同期对照组,差异有统计学意义(P<0·05)。两组住院期间均无心脏事件发生。结论 PCI术前给予丹参川芎嗪注射液能够有效抑制血小板的激活,改善术后心肌血流灌注,降低心肌损伤的发生。

英文摘要:

Objective To observe the effect of Danshen Chuanxiongqin Injection(DCI) on the myocardial damage of unstable angina(UA) patients undergoing percutaneous coronary intervention(PCI).Methods 76 UA patients were randomly assigned to the test group(39 cases) and the control group(37 cases).Routine treatment of Western medicine and PCI were given to all patients.But 10 mL DCI was intravenously dripped to patients in the test group by adding in 250 mL normal saline three to five days before PCI,once daily,lasting for 7 to 10 days.Changes of platelet P-selectin positive expressions before and after medication,the thrombolysis in myocardial infarction(TIMI),myocardial perfusion(TMP) score,levels of creatine kinase-myocardial band(CK-MB) and troponin Ⅰ(TnⅠ) after PCI were observed in the two groups.Results After medication the P-selectin positive expressions was lower in the test group than in the control group(2.45%±1.42% vs 4.43%±1.79%,P<0.05).After PCI the incidence of TMP 0/1,the levels of CK-MB and TnⅠ were lower in the test group than in the control group at the same phase,showing statistical difference(P<0.05).No cardiac event occurred in the two groups during the hospital stay.Conclusion Administration of DCI before PCI could effectively inhibit the activation of platelets,improve post-operative myocardial blood perfusion,and lower the incidence of the myocardial damage.

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