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Received:May 30, 2020 Published Online:March 20, 2021
Received:May 30, 2020 Published Online:March 20, 2021
中文摘要: 目的 探讨比伐芦定联合复方丹参滴丸对急性心肌梗死(AMI)冠脉介入(PCI)后心功能与肾胺酶(renalase)、血管生成素2(Ang-2)水平的影响。方法 选取2017年9月至2019年11月皖北煤电集团总医院AMI患者120例进行前瞻性随机对照研究,以随机数字表将患者分为联合组、对照A组、对照B组,各40例。3组均予以PCI及常规治疗,在此基础上,围术期对照A组给予比伐芦定,对照B组给予复方丹参滴丸,联合组予以比伐芦定联合复方丹参滴丸。对比3组术前、术后1周心功能指标[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)]、血液流变学指标(血浆黏度、全血低切黏度、全血高切黏度、红细胞比容)、血清炎症因子指标[白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)]、内皮细胞功能指标[一氧化氮(NO)、内皮素-1(ET-1)]、肾胺酶、Ang-2水平,并随访1个月,统计3组术后1个月并发症发生情况。结果 联合组术后1周LVEF高于对照A组、对照B组,LVESD、LVEDD水平低于对照A组、对照B组(P<0.05);联合组术后1周血浆黏度、全血低切黏度、全血高切黏度、红细胞比容低于对照A组、对照B组(P<0.05);联合组术后1周血清IL-6、hs-CRP、TNF-α低于对照A组、对照B组(P<0.05);联合组术后1周血清NO高于对照A组、对照B组,ET-1低于对照A组、对照B组(P<0.05);联合组术后1周肾胺酶、Ang-2低于对照A组、对照B组(P<0.05);3组术后并发症发生率相比,差异有统计学意义(P<0.05)。结论 比伐芦定联合复方丹参滴丸能改善AMI患者PCI后心功能,优化血液流变学,抑制炎症反应,改善血管内皮功能。
Abstract:Objective To investigate the effects of bivalirudin combined with Compound Danshen Dripping Pills (CDDP) on cardiac function and levels of renalase and angiopoietin 2 (Ang-2) in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods A total of 120 patients with AMI in Wanbei Coal and Power Group General Hospital from September 2017 to November 2019 were selected for prospective randomized controlled study.The patients were randomly divided into combination group,control group A and control group B (n=40,each).Based on PCI and routine treatment,during the perioperative period,bivalirudin was given in control group A,CDDP was given in control group B,and bivalirudin combined with CDDP was given in combination group.The indexes of cardiac function[left ventricular ejection fraction (LVEF),left ventricular end systolic diameter (LVESD),left ventricular end diastolic diameter (LVEDD)],hemorheology indexes(plasma viscosity,low shear whole blood viscosity,high shear whole blood viscosity,hematocrit),serum inflammatory factors[interleukin-6 (IL-6),high sensitivity C-reactive protein (hs-CRP),tumor necrosis factor-α (TNF-α)],indexes of endothelial cell function[nitrogen oxide (NO),endothelin-1 (ET-1)]and levels of renalase and Ang-2 were compared before PCI and 1 week after PCI among three groups.The patients were followed up for one month to observe the incidence of complications in three groups. Results At one week after PCI,all indicators above mentioned and the levels of renalase and Ang-2 were significantly lower in combination group than those in control group A and control group B except LVEF and NO,which were significantly higher than those in control group A and control group B (P<0.05).There was significant difference in the incidence of complication among three groups (P<0.05). Conclusion Bivalirudin combined with CDDP can improve heart function,hemorheology and vascular endothelial function and inhibit inflammation in AMI patients after PCI.
keywords: Bivalirudin Compound Danshen dripping pills Acute myocardial infarction Percutaneous coronary intervention Cardiac function Renalase Angiopoietin 2
文章编号: 中图分类号: 文献标志码:A
基金项目:
Author Name | Affiliation |
LU Wei,ZHU Kun,ZHENG Yu-shui | Department of Cardiology,Wanbei Coal and Electric Power Group General Hospital,Suzhou,Anhui 234000,China |
Author Name | Affiliation |
LU Wei,ZHU Kun,ZHENG Yu-shui | Department of Cardiology,Wanbei Coal and Electric Power Group General Hospital,Suzhou,Anhui 234000,China |
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