| Objective:Observate the effects of Shenmai Injection on acute myocardial infarction undergoing primary percutaneous coronary intervention (percutaneous coronary intervention PCI) for patients with cardiac function、ultrasonic Beckoning map change、 ST segment of ECG falling rate and plasma brain natriuretic peptide (Brain natriuretic peptide BNP)、cardiac injury markers creatine kinase (CK-MB) and cardiac troponin (cTnT) changes、the incidence of major cardiovascular events, to investigate the protective effects of Shenmai Injection on myocardium after reperfusion in patients with acute myocardial infarction.Methods:1. The research use stochastically, the comparison clinical trial method, select the Nnanyangyizhuan hospital heat center line of acute myocardial infarction (AMI) with pCI patients78cases example has carried observation from June,2011to June2013, divides into the treatment group and the control group by the method of random Numbers table randomly, each group of39cases each.2.patients in the treatment group immediately after admission oral loading aspirin (Bai Aspirin)300mg, Clopidogrel (Plavix)600mg, Atorvastatin (Lipitor)40mg,intravenous infusion of nitrates,while giving Shenmai Injection (10ml/support)50ml+glucose or saline intravenous injection, once a day, seven days for a course.Immediately give emergency PCI, and antiplatelet therapy conventional after surgery, The control group were given western medicine and emergency coronary interventional surgery only.3.Before treatment and one week after surgery、ninty days after surgery,observed patients (NYHA) cardiac functional class, left ventricular end-diastolic diameter ultrasound measurements (LVEDD), left ventricular systolic diameter (LVEDD), left ventricular ejection fraction (LVEF),plasma brain natriuretic peptide levels and cardiac injury markers, record ECG ST-segment case, and the incidence of major cardiovascular events.4.The resulting data is entered into the computer, using SpSS11.0software for statistical analysis.Results:1. NYHA case, Before treatment, cardiac function was no significant difference (P>0.05), after treatment, cardiac function was no significant difference (p>0.05), after treatment, the difference between the control group and the treatment group was nostatistically significant(P=0.27>0.05), but there were statistically significant differences in the treatment groupbetween before treatment andafter treatment, the difference was statistically significant (Pp=0.0037<0.05).2.Left ventricular ejection fraction (LVEF)、left ventricular end-diastolic diameter (LVEDD)、left ventricular systolic diameter (LVEDD) and ST segment back down rates all were improved by treatment in two groups (P<0.01or P<0.05), the difference between the two groups was statistically significant.3.Comparison of the control group and the treatment group serum BNp levels and cardiac injury markers, before treatment, no statistically significant difference on BNp concentration and cardiac injury markers, the BNP concentration and cardiac injury markers in two groups decreased significantly by treatment.The treatment group decreased more significantly, the decreasing has significant difference (P<0.05).4.Major cardiovascular events (including cardiac death, new-onset heart failure, non-fatal myocardial infarction, target vessel revascularization) compared, the cardiovascular eventrates in the control group is30.8%, it is5.1%in the treatment group, the incidence of cardiovascular events in the experimental group was significantly lower than the control group, with statistical significance (P<0.05).Conclusion:Shenmai Injection treatment acute myocardial infarction patients who had execute PCI, can improve myocardial microcirculation perfusion in patients undergoing emergency PCI, improve heart function, improve ventricular remodeling, can reduce the incidence of major cardiovascular events, Can improve the quality of life in patients with acute myocardial infarction PCI. |
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