浙江医学2017，Vol.39Issue(17)：1428-1432,5.DOI:10.12056/j.issn.1006-2785.2017.39.17.2017-282
羟苯磺酸钙对急性ST段抬高型心肌梗死急诊PCI术后疗效观察
Efficacy of calcium dobesilate for patients with acute ST-segment elevation myocardial infarction after emergency PCI
摘要
Abstract
Objective To evaluate the efficacy of calcium dobesilate (CD) for patients with acute ST-segment elevation myocardial infarction (STEMI) after percutaneous coronary intervention (PCI).Methods One hundred and sixty four patients with STEMI who underwent emergency PCI treatment from October 2013 to October 2016 were randomly divided into two groups.The control group received the conventional treatment,CD (500mg tid,for 3 months) was given to study group in addition to conventional treatments.The serum levels of creatine kinase MB (CK-MB) and troponin I (Tnl) were measured within 72h after operation.The serum levels of N-terminal probrain natriuretic peptide (NT-proBNP),high-sensitivity C-reactive protein (hs-CRP),endothelin-1 (ET-1),nitric oxide (NO) and the hemorheology parameters,including whole blood viscosity,plasma viscosity,erythrocyte aggregation index (EDI) and platelet aggregation rate were detected before and at various time points after operation.Echocardiography and 6-minute walk test (6MWl) were performed 3 after months after PCI treatment.Results Baseline characteristics were similar between two groups.There was no statistic difference in infarct size expressed as the AUC of CK-MB and Tnl between two groups.Left ventricular end-systolic volume (LVESV),left ventricular ejection fraction (LVEF),wall motion score index (WMSI),and 6MWT were significantly higher in the study group than those in control group at 3 months postoperatively.The levels of NT-proBNP,hs-CRP and ET-1 in the study group were significantly lower than those in the control group.Besides,the NO content in study was higher than that in the control group.The hemorheology was significantly improved in the study group.Conclusion CD does not reduce the infarct size shortly after emergency PCI in patients with STEMI.However,it can improve cardiac function later,which may be related to the improvement of coronary microcirculation by reducing the systemic inflammatory response,ameliorating coronary endothelial function and hemorheological properties.The drug can be used as adjunctive therapy in the treatment of myocardial infarction after reperfusion.关键词
急性ST段抬高型心肌梗死/经皮冠状动脉介入治疗/羟苯磺酸钙/冠状动脉微循环Key words
Acute ST-segment elevation myocardial infarction/Percutaneous coronary intervention/Calciumdobesilate/Coronary microcirculation引用本文复制引用
王江挺,刘小伟,岑镇波,唐礼江..羟苯磺酸钙对急性ST段抬高型心肌梗死急诊PCI术后疗效观察[J].浙江医学,2017,39(17):1428-1432,5.基金项目
浙江省重大科技专项计划项目(2012C13018-1) （2012C13018-1）
浙江省医药卫生科技项目(2015128660) （2015128660）
