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目的探讨丹参多酚酸盐在急性心肌梗死伴高血压患者经皮冠状动脉介入术(PCI)后中的治疗作用。方法随机将116例急性心肌梗死伴高血压需接受PCI治疗的患者分为观察组与对照组,对照组采取常规治疗,观察组在对照组基础上加以丹参多酚酸盐治疗,比较两组治疗后不同时间点心肌指标、治疗前后血小板活化、血管内皮及炎症因子指标。结果与治疗前比较,治疗第7d CD63、CD62p、血浆丙二醛(MDA)、内皮素-1(ET-1)、E-选择素、P-选择素、C反应蛋白(CRP)水平均显著下降,一氧化氮(NO)水平显著上升,差异有统计学意义(P<0.05),且观察组治疗第7d上述指标均明显优于对照组(P<0.05)。观察组术后72h CK、CK-MB水平分别为(134.27±30.01)IU/L、(16.15±2.74)IU/L均显著低于对照组的(300.14±35.79)IU/L、(27.35±5.00)IU/L,差异有统计学意义(P<0.05)。两组不良反应发生率比较无显著差异(P>0.05)。结论丹参多酚酸盐对急性心肌梗死伴高血压患者PCI术后心肌有良好保护作用,能明显抑制血小板活化及炎症反应,改善患者血管内皮功能。
Objective To investigate the therapeutic effect of salvianolate on patients with acute myocardial infarction and hypertension after percutaneous coronary intervention (PCI). Methods One hundred and sixteen patients with acute myocardial infarction complicated with hypertension undergoing PCI were randomly divided into observation group and control group. The control group was treated with conventional therapy. The observation group was given Salviae polyphenols on the basis of the control group. Myocardial indexes at different time points, platelet activation before and after treatment, vascular endothelial and inflammatory cytokines. Results Compared with those before treatment, CD63, CD62p, plasma MDA, ET-1, E-selectin, P-selectin and C-reactive protein (CRP) (P <0.05), and the above indexes in the observation group on the 7th day were significantly better than those in the control group (P <0.05). The levels of CK and CK-MB in the observation group at 72h were (134.27 ± 30.01) IU / L and (16.15 ± 2.74) IU / L respectively, which were significantly lower than those in the control group (300.14 ± 35.79 IU / L and 27.35 ± 5.00 ) IU / L, the difference was statistically significant (P <0.05). There was no significant difference in the incidence of adverse reactions between the two groups (P> 0.05). Conclusion Salviae miltiorrhizae polyphenols have a good protective effect on myocardial infarction after PCI in patients with acute myocardial infarction and hypertension, which can significantly inhibit platelet activation and inflammatory response and improve vascular endothelial function.