通络养心汤对急性心肌梗死经皮冠状动脉介入术后高缺血风险患者血小板抑制率及出血事件的影响

目的:观察通络养心汤对于急性心肌梗死(AMI)经皮冠状动脉介入(PCI)术后合并高缺血风险行双抗血小板治疗的患者血小板抑制率及出血事件发生风险的影响。方法:选取接受PCI治疗且术后合并高缺血风险的96例AMI患者纳入本次研究,将入选患者随机均分为对照组与观察组,对照组于PCI术后采取双抗血小板治疗,观察组在对照组的基础上联合应用通络养心汤治疗;观察两组患者治疗后第1周与第4周时的血小板抑制率;治疗6个月后,观察两组患者血脂水平、心功能指标的改善情况;随访1年,评估两组患者生活质量,统计出血等不良事件发生率。结果:治疗后第4周时两组AA途径、ADP受体途径血小板抑制率均较第1周时改善,且观察组均优于对照组(P<0.05);治疗6个月后,对照组TC、TG、LDL-C水平及观察组TC、TG、LDL-C、HDL-C均较治疗前改善,且观察组各项血脂指标均优于对照组(P<0.05);治疗6个月后,两组LVEF、LVESD、LVEDD均较治疗前改善,且观察组各项心功能指标均优于对照组(P<0.05);随访1年,两组GQOL-I274量表评价均较治疗前改善,且观察组均优于对照组(P<0.05);随访1年,观察组患者中因冠心病再入院率、支架内再狭窄率与出血事件发生率均低于对照组(P<0.05)。结论:通络养心汤能够提高急性心梗术后高缺血风险患者行双抗血小板治疗的血小板抑制率,改善患者血脂水平,降低出血等不良事件的发生风险。

Effect of Tongluo Yangxin decoction in treating acute myocardial infarction combined with high risk of ischemia and evaluate the platelet inhibition rate and hemorrhage events risk

Objective:To observe the effect of Tongluo Yangxin decoction in treating acute myocardial infarction (AMI) undergoing percutaneous coronary intervention (PCI) combined with high risk of ischemia and evaluate the platelet inhibition rate and bleeding events risk. Methods:A total of 96 patients with AMI undergoing PCI combined with high risk of ischemia were enrolled. All patients were randomly divided into control group and observation group. The control group was treated with dual anti-platelet therapy after PCI,and the observation group was treated with Tongluo Yangxin decoction on the basis of the control group. After 1 week and 4 weeks of treatment,the platelet inhibition rate was observed. After 6 months of treatment,the improvement of blood lipid level and cardiac function indexes were observed. After 1 year of follow-up,the quality of life was assessed,and the incidence of adverse events such as hemorrhage was counted. Results:After 4 weeks of treatment,the platelet inhibition rate of AA pathway and ADP receptor pathway of the 2 groups were improved compared with the first week (all P <0.05),and the observation group was superior to the control group ( P <0.05). After 6 months of treatment,the levels of TC,TG,LDL-C in the observation group were all improved compared with before treatment (all P <0.05),and the blood lipid indexes in the observation group were better than the control group ( P <0.05). After 6 months of treatment,the LVEF,LVESD and LVEDD in the 2 groups were improved (all P <0.05) compared with before treatment,and the cardiac function indexes in the observation group were better than the control group ( P <0.05). After 1 year of follow-up,the GQOL-I274 scale in the 2 groups were improved (all P <0.05),and the observation group was better than the control group ( P <0.05);the re-admission rate,stent restenosis rate and bleeding event rate in the observation group were lower than the control group (all P <0.05). Conclusion:Tongluo Yangxin decoction in treating acute myocardial infarction undergoing dual antiplatelet therapy combined with high risk of ischemia is effective,and it can improve the blood lipid level,and reduce the platelet inhibition rate and hemorrhage events risk.