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目的:观察通梗汤联合抗血小板治疗对急性心肌梗死(AMI)患者冠状动脉介入手术(PCI)后心型脂肪酸结合蛋白(H-FABP)、血小板计数水平(PLT)及心血管事件的影响。方法:选取2013年3月至2014年9月于我院行PCI术的AMI患者88例为研究对象,采用随机数字表法分为观察组和对照组各44例,对照组给予西药治疗,观察组在此基础上加服通梗汤,两组均治疗2个月,比较其治疗有效率,测定两组治疗前后血浆H-FABP、N端B型脑钠肽(NT-proBNP)水平及PLT,应用彩色多普勒超声影像仪测定两组左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室射血分数(LVEF),同时观察两组心血管事件发生率。结果:观察组治疗有效率90.9%明显高于对照组72.7%(P<0.05);治疗后观察组H-FABP(24.31±1.25)ng/ml、NT-proBNP(2.78±0.15)pg/ml、PLT(2.01±0.14)10~(11)/L、LVEDD(44.39±3.25)mm、LVESD(39.14±3.31)mm与对照组比较明显降低(P<0.05),观察组LVEF(52.36±1.52)%高于对照组(P<0.05);观察组术后心血管事件发生率4.5%明显低于对照组18.2%(P<0.05)。结论:通梗汤联合抗血小板治疗可有效降低AMI患者PCI术后H-FABP、PLT水平及心血管事件发生率,改善其心功能,值得在临床推广应用。
Objective: To observe the effect of Tongzhi Decoction combined with antiplatelet therapy on cardiac fatty acid binding protein (H-FABP), platelet count (PLT) and cardiovascular events after percutaneous coronary intervention (PCI) in patients with acute myocardial infarction (AMI). Methods: From March 2013 to September 2014, 88 patients with AMI who underwent PCI in our hospital were enrolled in this study. According to the random number table, 44 patients were divided into observation group and control group, while those in control group were treated with western medicine. On the basis of this group, add Tongjie Decoction, both groups were treated for 2 months, the treatment efficiency was compared before and after treatment to determine the level of plasma H-FABP, N-terminal B-type brain natriuretic peptide (NT-proBNP) The left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD) and left ventricular ejection fraction (LVEF) were measured by color Doppler sonography. The incidences of cardiovascular events were also observed. Results: The effective rate of observation group was 90.9%, which was significantly higher than that of the control group (72.7%, P <0.05). The levels of H-FABP in the observation group were 24.31 ± 1.25 ng / ml and NT-proBNP were 2.78 ± 0.15 pg / Compared with the control group, the PLT (2.01 ± 0.14) 10-11 / LVEDD (44.39 ± 3.25) mm LVESD (39.14 ± 3.31) mm in the observation group was significantly lower than that in the control group (52.36 ± 1.52% (P <0.05). The incidence of postoperative cardiovascular events in the observation group was 4.5% lower than that in the control group (18.2%, P <0.05). Conclusion: Tongji decoction combined with antiplatelet therapy can effectively reduce the incidence of H-FABP, PLT and cardiovascular events and improve cardiac function after PCI in AMI patients, which is worthy of clinical application.