目的 探究烏司他丁聯(lián)合黃芪注射液治療心肌梗死PCI 術(shù)后炎癥反應的臨床療效.方法 選取2012 年7 月-2015年1 月重慶市涪陵中心醫(yī)院心內(nèi)科收治的急性心肌梗死并且成功完成PCI 醫(yī)治的患者86 例,隨機分為對照組和治療組,每組各43 例.對照組患者于PCI 術(shù)后靜脈滴注黃芪注射液30 mL/次,1 次/d.治療組靜脈滴注注射用烏司他丁,30 萬單位/次,1 次/d,黃芪注射液的用法用量同對照組.兩組均連續(xù)治療7 d.觀察兩組患者腫瘤壞死因子-α(TNF-α)、白細胞介素-1(IL-1)、細胞黏附分子-1(ICAM-1)、血清丙二醛(MDA)、血清肌酸磷酸激酶同工酶(CK-MB)峰值及CK-MB 曲線下面積的變化情況.結(jié)果 術(shù)后1 d 兩組患者IL-1、TNF-α、ICAM-1、MDA 水平均較術(shù)前有所提高,同組比較差異具有統(tǒng)計學意義(P< 0.05);術(shù)后3、7 d 兩組患者這些因子水平均顯著降低,且均低于同組治療前(P< 0.05),且治療組的降低程度優(yōu)于對照組,兩組比較差異具有統(tǒng)計學意義(P< 0.05).經(jīng)7 d 治療后,治療組CK-MB 峰值和CK-MB 曲線下面積均顯著低于對照組,兩組比較差異具有統(tǒng)計學意義(P< 0.05).結(jié)論 烏司他丁聯(lián)合黃芪注射液用于治療PCI 術(shù)后炎癥反應具有較好的臨床療效,可降低患者炎癥因子表達水平,降低缺血再灌注對心肌的損傷,具有重要的臨床應用價值.

Objective To investigate the efficacy of ulinastatin combined with Huangqi Injection in treatment of inflammation reaction of patients with myocardial infarction after PCI. Methods Patients (86 cases) with acute myocardial infarction who accepted PCI successfully in Department of Cardiology from Fuling Center Hospital of Chongqing City from July 2012 to January 2015 were randomly divided into control and treatment groups. Each group had 43 cases. Patients in control group were iv administered with Huangqi Injection 30 mL after PCI, once daily. Patients in treatment group were iv administered with Ulinastatin for injection, 300 000 U/time, once daily, and the usage and dosage of Huangqi Injection were the same with the control group. Two groups were treated for 7 d. After treatment, the changes of TNF-α, IL-1, ICAM-1, MDA, CK-MB peak, and the area under CK-MB curve in two groups were compared. Results IL-1, TNF-α, ICAM-1, and MDA in two groups were increased in the same group after 1 d postoperative, and the difference was statistically significant in the same group (P < 0.05). These factors were significantly reduced after 3, 7 d postoperative, and they were lower than the same group before treatment (P < 0.05). Reduce degrees of these factors in the treatment group were better than those in the control group, with significant differences between two groups (P < 0.05). CK-MB peak and the area under CK-MB curve in the treatment group were lower than those in the control, with significant differences between two groups (P < 0.05). Conclusion Ulinastatin combined with Huangqi Injection has clinical curative effect in treatment of inflammation reaction in patients with myocardial infarction after PCI, and can reduce the expression level of inflammatory factors, also can reduce the injury of ischemia reperfusion for myocardial, which has the important value of clinical