探讨中医治疗对心肌梗死患者介入治疗后心肌再灌注和心功能的改善作用陈兆琦.docVIP

探讨中医治疗对心肌梗死患者介入治疗后心肌再灌注和心功能的改善作用陈兆琦 鹤岗市工农区陈兆琦屮医诊所154101 摘 要 目的研究分析屮医治疗对心肌梗死(AMI)患者经皮冠状动脉内介 入治疗(PCI)后心肌再灌注和心功能的改善作用。方法此次研究的对象是选择 2013年2月 ?2014年2月在我院就诊并明确诊断为AMI急性期且具有PCI适 用征的83例患者，将患者的临床资料进行回顾性分析。并随机分为屮医综合治 疗组41例及对照组42例。两组均予PCI及西医相关治疗，屮医综合治疗组在此 基础上加用屮医屮药的治疗。观察并比较两组患者PCI术屮心肌梗死溶栓治疗 (TIMI)后心肌灌注分级(TMP)、PCI术后90 d的心功能相关指标左心室舒张末 容量(LVEDV)、左心室收缩末容量(LVESV)、每搏输出量(SV)及左心室射血体 积分数(LVEF)的变化情况。结果 ①屮医综合治疗组TMP2?3级患者37例， TMP0?1级患者4例，对照组分别为29、13例，屮医综合治疗组TMP 2?3级 所占比例明显高于对照组，差异有高度统计学意义(PIt; 0.01 )o②两组住院期 间心功能指标LVEDV、LVESV、SV、LVEF差异均无统计学意义(Pgt;0.05)o PCI 术后90d,对照组LVESV、SV、LVEF等指标均明显优于同组住院期间，差异均有 统计学意义(P It; 0.05或P It; 0.01),而LVEDV与住院期间比较，差异无统计 学意义(P gt; 0.05)；屮医综合治疗组患者PCI术后90 d的LVEDV、LVESV、SV、 LVEF 等心功能指标［(122.47plusmn;38.45) (66.07plusmn;20.20)、 (75.01plusmn;18.12) mL, (52.84plusmn;6.07) %］均明显优于同组住院期间, 差异均有统计学意义(PIt; 0.05或P lt; 0.01),且LVESV、SV、LVEF均显著优 于对照组［(77.45plusmn;17.31) (67.03plusmn;15.49) mL, (48.25plusmn;7.57) %］,差异均有统计学意义(PIt; 0.05)o结论 依据PCI 治疗前后屮医疾病机制变化，在PCI基础上加以屮医治疗可以更明显地改善AMI 患者心肌再灌注情况，缩小心肌梗死灶，改善心功能。 关键词 中医治疗；急性心肌梗死；经皮冠状动脉内介入治疗；心肌再灌 [Abstract] Objective To study the effects of traditional Chinese medicine (TCM) on myocardial reperfusi on and cardiac f unction after percuta neous cor on ary in tervention (PCI) in patie nts with myocardial infarction (AMI) . Methods the study subjects were selected from February 2014 to February 2013 in our hospital and a clear diagnosis of AMI acute phase and with PCI application of 83 patients, the clinical data of patients were retrospectively analyzed. And randomly divided into 41 cases of traditional Chinese medicine comprehensive treatment group and 42 cases of the control group. The two groups were treated with PCI and Western medicine, the traditional Chinese medicine treatment group on the basis of the treatment of traditional Chinese medicine. Observation and compared two groups of patients with PCI center myocardial infarction thrombolytic therapy (TIMI) myocardial perfusion grade (TMP), PCI after 90 days of the cardiac function