实用医学杂志 ›› 2021, Vol. 37 ›› Issue (5): 671-675.doi: 10.3969/j.issn.1006⁃5725.2021.05.022

• 中医药现代化 • 上一篇    下一篇

冠心舒通胶囊对急性ST段抬高型心肌梗死急诊介入术后微循环功能以及预后的影响

陈亚南, 郭秋红, 姜涛, 冯雁, 秦雷   

  1. 开封市中心医院1 心内科,2 超声室(河南开封475000);3 开封市中医院心内科(河南开封475000)

  • 出版日期:2021-03-10 发布日期:2021-03-10
  • 通讯作者: 冯雁 E⁃mail:xne62504@163.com
  • 基金资助:

    河南省医学科技攻关计划项目基金资助项目(编 号:LHGJ20191173);开封市科技发展计划项目基金资助项目(编 号:2003076)

Effect of Guanxinshutong Capsule on microcirculation function and prognosis in patients with Acute ST⁃ segment elevation myocardial infarction after emergency percutaneous coronary intervention

CHEN Ya′nan, GUO Qiuhong,JIANG Tao,FENG Yan,QIN Lei.   

  1. Department of Cardiology,the Central Hospital of Kaifeng Kaifeng 475000,China

  • Online:2021-03-10 Published:2021-03-10
  • Contact: FENG Yan E⁃mail:xne62504@163.com

摘要: 目的 探讨冠心舒通胶囊对急性ST段抬高型心肌梗死(STEMI)急诊介入术后(PCI)微循环及预后的影响。方法 210 例行急诊PCI 的STEMI 患者随机分两组,一组为常规药物组(= 112),另一组常规治疗联合冠心舒通胶囊(= 98);PCI术后、出院 1 年分别行心脏彩超及心肌声学造影,比较两组左室舒张末容量、左室射血分数、造影剂评分指数(CSI)等指标,并随访出院后1年是否发生MACE事件。结果 (1)入院 CSI 水平两组无差异,随访CSI在冠心舒通组明显降低(= 0.039)。(2)冠心舒通组(14.3%)MACE发生率低于常规药物组(25.9%)(= 0.041)。(3)多因素logistic 回归显示随访 CSI MACE 事件的独立危险因素(HR = 4.21,= 0.040)。结论 冠心舒通胶囊可以改善STEMI 急诊PCI 术后心肌微循环,抑制心肌重塑,降低MACE事件;随访CSI是发生MACE独立危险因素。

关键词:

冠心舒通胶囊, 急性ST段抬高型心肌梗死, 急诊冠脉介入治疗, 心肌微循环, 预后

Abstract:

Objective To observe the effect of Guanxinshutong(GXST)Capsule on myocardial microcir⁃ culation and prognosis in patients with Acute ST⁃segment Elevation Myocardial Infarction(STEMI)after Emergency percutaneous coronary intervention(PCI). Methods A total of 210 patients with STEMI who underwent emergency PCI were randomly divided into two groups. One group was treated with conventional therapy(control group,n = 112)while the other with conventional therapy plus GXST Capsule(GXST group,n = 98). Cardiac ultrasound and myocardial contrast echocardiography were performed on admission and after 1 ⁃ year follow ⁃ up respectively. LVEDV,LVEF and contrast score index(CSI)were recorded and compared. they were followed up to determine whether MACE occurred 1 year later. Results CSI on admission had no difference between the two groups but was significantly lower in GXST group after 1⁃y follow⁃up(P = 0.039). MACE in GXST group(14.3%)was significantly lower than that in the control group(25.9%)(P = 0.041). Multivariate logistic regression analysis demonstrated that the CSI after 1 ⁃ y follow up was an independent predictor for MACE(HR = 4.21,P = 0.040). Conclusion GXST Capsule can improve myocardial microcirculation function in patients with STEMI after emergency PCI and it can also inhibit myocardial remodeling and reduce the occurrence of MACE. CSI level after 1⁃y follow⁃up is an inde⁃pendent risk factor for MACE. 

Key words:

guanxinshutong capsule, acute ST ? segment elevation myocardial infarction, emergency percutaneous coronary intervention, myocardial microcirculation, prognosis