复方丹参滴丸辅助治疗急性心肌梗死的临床研究

目的：观察急性心肌梗死(AMI)患者采用经皮冠状动脉介入术(PCI)术后联合复方丹参滴丸辅助治疗的临床疗效,分析其对AMI患者心功能的影响机制。方法：本临床研究将将我院心血管内科门诊于2017年4月～2018年3月期间收治的135例AMI患者分为对照组(n=69)和观察组(n=67),均于接诊后即刻PCI处理,观察组在对照组常规急诊用药的治疗基础加服复方丹参滴丸。采用免疫抑制法检测血清超氧化物歧化酶(SOD)、肌酸激酶(CK)和肌酸激酶(CK-MB)；比较两组PCI术前和治疗7天(d)时血清心肌钙调蛋白依赖性蛋白激酶Ⅱ(CaMKⅡ)、心肌肌钙蛋白I(cTnI)和心肌肌钙蛋白T(cTnT)蛋白表达,并比较不同治疗对AMI患者心功能的影响,统计临床疗效及心脏不良事件,籍此讨论复方丹参滴丸治疗AMI的应用价值。结果：治疗7d时,ELISA检测显示观察组血清CaMKⅡ、cTnI和cTnT蛋白均明显低表达,CK和CK-MB明显降低,SOD升高,与PCI术前比差异有统计学意义(P＜0.05),且观察组SOD与对照组比较差异有统计学意义(P＜0.05)。心功能监测显示观察组患者等容收缩期左心室内压力下降最大速率(-dp/dtmax)、左室舒张未期内径(LVEDD)和左室收缩未期内径(LVESD)降低,而等容收缩期左心室内压力最大上升速率(+dp/dtmax)、左室射血分数(LVEF)和左心房射血量(LASV)均较PCI术前升高(P＜0.05)；且观察组-dp/dtmax、LVEDD和LVESD显著低于对照组,+dp/dtmax、LASV和LVEF均显著高于对照组(P＜0.05)。观察组总有效率(85.07%)高于对照组(75.36%),且住院期间死亡率(2.98%)和心律失常(7.24%)低于对照组(P＜0.05)。结论：复方丹参滴丸可显著改善AMI患者PCI术后心功能,提高临床疗效,降低并发症和死亡率。

Clinical study of Compound Danshen Dripping Pills in the treatment of acute myocardial infarction

Objective: To observe the clinical efficacy of combined percutaneous coronary intervention (PCI) combined with compound salvia miltiorrhiza dropping pills (RSM) after percutaneous coronary intervention (AMI), and to analyze the mechanism of its effect on the cardiac function of patients with AMI. Methods: 135 patients with AMI in our hospital from April 2017 to March 2018 were divided into the control group (n =69) and the observation group (n =67). All the patients were treated with PCI treatment immediately after receiving the treatment. The observation group was given the compound salvia miltiorrhiza dripping pills on the basis of the conventional treatment in the control group. Serum superoxide dismutase (SOD), creatine