灯盏花素注射液联合比伐芦定对急性心肌梗死患者PCI术后心电图指标及心功能的影响

【目的】探讨灯盏花素注射液联合比伐芦定对急性心肌梗死(AMI)患者介入术后心电图指标及心功能的影响。【方法】前瞻性选择2018年2月至2020年4月辽阳市中心医院收治的行PCI术治疗的116例AMI患者为研究对象,采用随机数表法将其分为观察组和对照组,每组各58例。对照组在常规治疗基础上给予比伐芦定治疗,观察组在对照组的基础上给予灯盏花素注射液治疗。比较两组患者治疗后心肌梗死溶栓(TIMI)血流分级、心功能指标左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)]、血清指标白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、血清心脏型脂肪酸结合蛋白(H-FABP)、缺血修饰白蛋白(IMA)、肌钙蛋白丁(CTnT)水平]及心电图情况体表心电图QT离散度(QTd)、ST段回落]。治疗后随访3个月,记录两组患者主要不良心血管事件(MACE)发生情况。【结果】治疗后,两组患者TIMI血流分级较治疗前改善,且观察组优于对照组,差异有统计学意义(P<0.05);两组患者LVEF水平高于治疗前,LVESD、LVEDD水平低于治疗前,且观察组与对照组存在差异,差异均有统计学意义(均P<0.05)。两组患者血清H-FABP、IMA、cTnT、IL-6、TNF-α水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。两组患者QTd均低于治疗前,且观察组低于对照组(P<0.05);观察组ST段回落良好率高于对照组(P<0.05)。治疗后3个月随访,观察组、对照组各脱落1例,观察组MACE发生率为7.02%(4/57),低于对照组的21.05%(12/57),差异有统计学意义(χ²=4.653,P=0.031<0.05)。【结论】灯盏花素注射液联合比伐芦定治疗可改善AMI患者PCI术后心肌灌注、心电图情况及心功能,减轻机体炎症反应,降低血清H-FABP、IMA、TnT水平,减轻心肌损伤,降低MACE发生率,对改善患者预后具有重要意义。

Effects of Breviscapine Injection Combined with Bivalrudin on the Electrocardiogram and serum H-FABP,IMA and TnT levels in patients with AMI after Intervention

Objective]To investigate the efets of breviscapine injection combined with bivalrudin on the electrocar-diogram and serum cardiac fatty acid binding protein(H-FABP),ischemia modifying albumin(IMA)and troponin T(TnT)levels in patients with acute myocardial infarction(AMI)after intervention,Methods]A total of 116 AMI pa-tients undergoing PCI surgery admitted to our hospital from February 2018 to April 2020 were pelected as the research ob-jects.They were divided into observation group(n=58)and control group(n=58)by simple randomization method.On the basis of conventional treatment.the control group was given bivalrudine.and the observat ion group was given bre-viscapine injection combined with bivalrudine.The TIMI blood flow classification,cardiac function indexes(LVEF,LVESD,LVEDD),serum indexes(IL-6,TNF-α,HFABP,IMA,cTnT)and electrocardiogram(QT dispersion of surface letrocardiogram(QTd)。ST segment depression)were compared between the two groups after treatment.The patients were followed up for 3 months after trcatment,and the major adverse cardiovascular events(MACE)of the two groups were recorded.Results]After treatment,TIMI blood flow classification of the two groups was improved.and the observation group was better than the control group,the iference was stistically significant(P<0.05);LVEF level of the two groups was higher than that before treatment,LVESD and LVEDD levels were lower than that before treat-ment,and there were dilrerences between the observation group and the control group.the differences were staistically significant(all P<0.05).The serum levels of HFABP,IMA,cTnT.IL-6 and TNF-α in the two groups were lower than those before treatment.and those in the observation group were lower than those in the control group(P<0.05).QTd of the two groups were lower than before treatment,and the observation group was lower than the control group(P<0.05);the good rate of ST segment depresion of the observation group was higher than that of the control group(P<0.05).After 3 months of fllow up.the observation group and the control group had 1 case of shedding.The inci-dence of MACE in the observation group was 7.02%(4/57).which was lower than 21.05%(12/57)in the control group,and the difrence was stistically significant(χ²=4.653,P-0.031<0.05).Conclusion]Breviscapine injection combined with bivalirudin can improve myocardial perfusion,electrocardiogram and cardiae function.reduce inflammatory reaction,serum H-FABP,IMA and TnT levels,reduce myocardial injury and reduce the incidence of MACE in patients with AMI after PCI,which is of great signifcance to improve the prognosis of patients.