【摘要】 目的 探讨麝香保心丸联合血栓抽吸对急性ST段抬高型心肌梗死（STEMI）患者直接经皮冠脉介入术后的近期疗效。方法 选择南昌市第一医院2020年4月至2022年12月收治的144例行直接PCI的急性STEMI患者为研究对象，采用随机数字表法将其分为A组（72例）、B组（72例）。B组患者采用血栓抽吸，A组患者给予麝香保心丸联合血栓抽吸（术前舌下含服麝香保心丸90 mg，术后口服麝香保心丸45 mg/次，3次/d）。比较两组术后即刻心肌梗死溶栓（TIMI）血流3级占比、术后2 h ST段回落>50%占比；比较两组术前及术后1个月左室射血分数（LVEF）和左室舒张末期内径（LVEDd）；比较两组住院及出院后30 d内主要心血管不良事件（MACE）的发生率。结果 A组术后即刻TIMI血流3级占比及术后2 h ST段回落>50%占比高于B组，差异有统计学意义（P<0.05）。术后1个月，两组LVEF高于术前，LVEDd低于术前；且A组LVEF高于B组，LVEDd低于B组，差异有统计学意义（P<0.05）。A组住院期间及出院30 d内MACE总发生率低于B组，差异有统计学意义（P<0.05）。结论在急性心肌梗死直接PCI治疗中，使用麝香保心丸联合血栓抽吸能有效改善心肌灌注和心功能，降低近期MACE发生率。更多还原

【Abstract】 Objective To explore the short-term efficacy of Shexiang Baoxin Pills combined with thrombus aspiration on patients with acute ST-elevation myocardial infarction(STEMI) after primary percutaneous coronary intervention(PCI).Methods A total of 144 patients with acute STEMI who accepted primary PCI in Nanchang First Hospital, Jiangxi Province from April 2020 to December 2022 were selected. They were divided into group A(72 cases) and group B(72 cases) by random number table method. Patients in group B were treated with thrombus aspiration, and patients in group A were treated with Shexiang Baoxin Pills combined with thrombus aspiration(taking Shexiang Baoxin Pills 90 mg sublingually before operation and taking Shexiang Baoxin Pills 45 mg/time, three times a day after operation). The proportion of postoperative thrombolysis in myocardial infarction(TIMI) blood flow grade three immediately after primary PCI and the proportion of ST segment regression>50% at two hours after PCI were compared between two groups; left ventricular ejection fraction(LVEF)and left ventricular end diastolic diameter(LVEDd)were compared between two groups before and one month after operation; and the incidence of major adverse cardiovascular events(MACE) in hospital and within 30 days after hospitalization was compared between two groups. Results The proportion of postoperative TIMI blood flow grade three immediately after primary PCI and the proportion of ST segment regression>50% at two hours after PCI in group A were higher than those in group B, and the differences were statistically significant(P < 0.05). One month after operation, LVEF was higher than that before operation, LVEDd was lower than that before operation; and LVEF in group A was higher than that in group B, LVEDd was lower than that in group B, and the differences were statistically significant(P <0.05). The total incidence of MACE in hospital and within 30 days after hospitalization in group A was lower than that in group B, and the difference was statistically significant(P <0.05). Conclusion In the primary PCI treatment of acute myocardial infarction, the use of Shexiang Baoxin Pills combined with thrombus aspiration can effectively improve myocardial perfusion and cardiac function, and reduce the incidence of recent MACE.更多还原