目的 探究乌司他丁联合黄芪注射液治疗心肌梗死PCI 术后炎症反应的临床疗效.方法 选取2012 年7 月-2015年1 月重庆市涪陵中心医院心内科收治的急性心肌梗死并且成功完成PCI 医治的患者86 例,随机分为对照组和治疗组,每组各43 例.对照组患者于PCI 术后静脉滴注黄芪注射液30 mL/次,1 次/d.治疗组静脉滴注注射用乌司他丁,30 万单位/次,1 次/d,黄芪注射液的用法用量同对照组.两组均连续治疗7 d.观察两组患者肿瘤坏死因子-α(TNF-α)、白细胞介素-1(IL-1)、细胞黏附分子-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 曲线下面积的变化情况.结果 术后1 d 两组患者IL-1、TNF-α、ICAM-1、MDA 水平均较术前有所提高,同组比较差异具有统计学意义(P< 0.05);术后3、7 d 两组患者这些因子水平均显著降低,且均低于同组治疗前(P< 0.05),且治疗组的降低程度优于对照组,两组比较差异具有统计学意义(P< 0.05).经7 d 治疗后,治疗组CK-MB 峰值和CK-MB 曲线下面积均显著低于对照组,两组比较差异具有统计学意义(P< 0.05).结论 乌司他丁联合黄芪注射液用于治疗PCI 术后炎症反应具有较好的临床疗效,可降低患者炎症因子表达水平,降低缺血再灌注对心肌的损伤,具有重要的临床应用价值.

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