Short-term efficacy of Shexiang Baoxin Pills combined with thrombus aspiration on patients with acute ST-elevation myocardial infarction after primary percutaneous coronary intervention
WANG Guiming LI Shunhui ZHONG Tao HE Tao CHEN Hui
Ward One, Department of Cardiology, Nanchang First Hospital, Jiangxi Province, Nanchang 330000, China
Abstract：Objective To explore the short-term efficacy of Shexiang Baoxin Pills combined with thrombus aspiration on patients with acute ST-elevation myocardial infarction (STEMI) after primary percutaneous coronary intervention (PCI). Methods A total of 144 patients with acute STEMI who accepted primary PCI in Nanchang First Hospital, Jiangxi Province from April 2020 to December 2022 were selected. They were divided into group A (72 cases) and group B (72 cases) by random number table method. Patients in group B were treated with thrombus aspiration, and patients in group A were treated with Shexiang Baoxin Pills combined with thrombus aspiration(taking Shexiang Baoxin Pills 90 mg sublingually before operation and taking Shexiang Baoxin Pills 45 mg/time, three times a day after operation). The proportion of postoperative thrombolysis in myocardial infarction (TIMI) blood flow grade three immediately after primary PCI and the proportion of ST segment regression＞50% at two hours after PCI were compared between two groups; left ventricular ejection fraction （LVEF） and left ventricular end diastolic diameter （LVEDd） were compared between two groups before and one month after operation; and the incidence of major adverse cardiovascular events (MACE) in hospital and within 30 days after hospitalization was compared between two groups. Results The proportion of postoperative TIMI blood flow grade three immediately after primary PCI and the proportion of ST segment regression＞50% at two hours after PCI in group A were higher than those in group B, and the differences were statistically significant (P ＜ 0.05). One month after operation, LVEF was higher than that before operation, LVEDd was lower than that before operation; and LVEF in group A was higher than that in group B, LVEDd was lower than that in group B, and the differences were statistically significant (P ＜0.05). The total incidence of MACE in hospital and within 30 days after hospitalization in group A was lower than that in group B, and the difference was statistically significant (P ＜0.05). Conclusion In the primary PCI treatment of acute myocardial infarction, the use of Shexiang Baoxin Pills combined with thrombus aspiration can effectively improve myocardial perfusion and cardiac function, and reduce the incidence of recent MACE.
王贵明 李顺辉 衷 涛 何 涛 陈 晖. 麝香保心丸联合血栓抽吸对急性ST段抬高型心肌梗死患者直接经皮冠脉介入术后的近期疗效[J]. 中国医药导报, 2023, 20(35): 84-87,114.
WANG Guiming LI Shunhui ZHONG Tao HE Tao CHEN Hui. Short-term efficacy of Shexiang Baoxin Pills combined with thrombus aspiration on patients with acute ST-elevation myocardial infarction after primary percutaneous coronary intervention. 中国医药导报, 2023, 20(35): 84-87,114.
[1] McQuillan C，Gray A，Kearney A，et al. Advances in Clin Cardiology 2017：A Summary of Key Clin Trials [J]. Adv T- her，2018，35（7）：899-927． [2] 杨文，刘洁云，秦雷，等.血栓抽吸联合冠状动脉内应用重组人尿激酶原对存在血栓负荷的急性ST段抬高型心肌梗死患者近期预后与安全性的影响[J].中国老年学杂志，2021，41（5）：909-913. [3] 金骁琦，盛晓东，范韬，等.血栓抽吸并替罗非班加硝普钠冠脉内注射用于急性右冠状动脉闭塞患者PCI对冠脉血流、心功能的影响[J].中国医学创新，2019，16（34）：23-26. [4] 张伯亨，张亚静，岳博成，等.尿激酶原联合血栓抽吸对高血栓负荷的STEMI患者的疗效观察[J].医学研究杂志，2018，47（5）：179-182. [5] 李学香.经导管预处理血栓对ST段抬高型心肌梗死直接冠状动脉介入术的影响和临床意义[J].新医学，2018， 49（8）：590-595. [6] Ahn SG，Choi HH，Lee JH，et al. The impact of initial and residual thrombus burden on the no-reflow phenomenon in patients with ST segment elevation myocardial infarction [J]. Coron Artery Dis，2015，26（3）：245-253. [7] 施珊岚，张艳达，贺治青，等.麝香保心丸对心肌梗死小鼠微循环障碍的作用研究[J].中西医结合心脑血管病杂志，2017，15（5）：547-551. [8] 黄静静，陈浩，李霖睿，等.麝香保心丸联合冠脉内注射尼可地尔对STEMI患者PPCI术后心肌血流灌注及近期预后的影响[J].药学实践杂志，2022，40（1）：79-83. [9] 康利锐，袁晶晶，阿那日，等.芪参益气滴丸对非阻塞性冠状动脉缺血疾病患者冠状动脉微循环功能障碍的影响[J].中南药学，2021，19（5）：1014-1018. [10] Tian J，Zhang L，Yang X，et al. The effect of Shexiang Tong- xin Dropping Pills on coronary microvascular dysfunction（CMVD）among those with a mental disorder and non-obstructive coronary artery disease based on stress cardiac magnetic resonance images：A study protocol [J]. Medicine（Baltimore），2020，99（21）：e20099. [11] Wang M，Shan Y，Sun W，et al. Effects of Shexiang Baoxin Pill for coronary microvascular function：A systematic review and Meta-analysis [J]. Front Pharmacol，2021，12：751050. [12] 急性ST段抬高型心肌梗死诊断和治疗指南（2019）[J]. 中华心血管病杂志，2019，47（10）：766-783. [13] 协会心血管内科医师分会血栓防治专业委员会，中华心血管病杂志编辑委员会.中国经皮冠状动脉介入治疗指南（2016）[J].中华心血管病杂志，2016，44（5）：382-400. [14] Vlaar PJ，Svilaas T，van der Horst IC，et al. Cardiac death and reinfarction after 1 year in the Thrombus Aspiration during Percutaneous coronary intervention in Acute myocardial infarction Study（TAPAS）：a 1-year follow-up study [J]. Lancet，2008，371（9628）：1915-1920. [15] Jolly SS，Cairns JA，Yusuf S，et al. Randomized trial of primary PCI with or without routine manual thrombectomy [J]. N Engl J Med，2015，372（15）：1389-1398. [16] Jolly SS，Cairns J，Yusuf S，et al. Design and rationale of the TOTAL trial：a randomized trial of routine aspiration ThrOmbecTomy with percutaneous coronary intervention（PCI）versus PCI ALone in patients with ST-elevation myocardial infarction undergoing primary PCI [J]. Am Heart J，2014，167（3）：315-321. [17] Barkagan M, Steinvil A, Berchenko Y, et al. Impact of routine manual aspiration thrombectomy on outcomes of patients undergoing primary percutaneous coronary intervention for acute myocardial infarction: A meta-analysis [J]. Int J cardiol，2016，204：189-195. [18] 李红梅.在高龄ST段抬高型心肌梗死患者PCI治疗中冠脉内注射替罗非班的效果[J].心血管康复医学杂志，2018，27（3）：326-331. [19] 张丽颖，郭富蒸，于浩南，等.PCI术后应用替罗非班致极重度血小板减少1例[J].中国实验诊断学，2018，22（1）：176-177. [20] 陈奕权，庄曼茹，李春来，等.麝香保心丸对冠心病患者血液流变学与血管新生的影响及其作用机制[J].世界中西医结合杂志，2020，15（4）：666-669. [21] 张学洪，曾林飞，陈斌.麝香保心丸联合复方血栓通胶囊治疗经皮冠状动脉介入术术后短期冠脉慢血流的临床分析[J].中国当代医药，2021，28（31）：60-62，66. [22] 景丽英，郑俊华.麝香保心丸联合倍他乐克对冠心病心绞痛患者心电图及心功能指标的影响[J].中国医药科学，2021，11（14）：71-74. [23] 齐娜，段文娟，李雅婧，等.麝香酮药理作用的研究进展[J].世界科学技术-中医药现代化，2020，22（8）：3042- 3047. [24] 高健，吕邵娃.人参化学成分及药理作用研究进展[J].中医药导报，2021，27（1）：127-130，137. [25] 陈旭，刘畅，马宁辉，等.肉桂的化学成分、药理作用及综合应用研究进展[J].中国药房，2018，29（18）：2581- 2584. [26] 陈念.苏合香对心肌缺血模型大鼠的影响及机制研究[D].成都：成都中医药大学，2019. [27] 苏坤莲，凡永杰，刘原，等.冰片对心脑血管系统药理作用及其机制的研究进展[J].辽宁中医杂志，2018，45（9）：2001-2003.
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