杜燕宾 郑若龙 钱惠东

[摘要] 目的 研究ACS行PCI治療的患者在冠心病常规药物治疗的基础上坚持服用脑心通胶囊对其近期预后的影响。方法 方便选取江阴市人民医院心内科2013年10月—2016年10月收治的确诊并行PCI的ACS患者121例，随机分成脑心通组和常规组，脑心通组在常规组冠心病二级药物治疗基础上坚持口服脑心通胶囊，随访1年中患者心绞痛发作、心电图变化、再发心梗、心功能情况、脑卒中以及死亡等相关临床指标。结果 脑心通组无心梗发生。术后1年脑心通组的控制心绞痛总有效率为95.08%，较常规组的83.33%明显要高。两组差异有统计学意义（χ2=4.35 3 9，P=0.036 8）。术后1年脑心通组心电图改善的总有效率为98.36%，较常规组的86.67%明显要高（χ2=6.008 0，P=0.014 2）。经治疗1年后两组患者心胸比、LVED较出院前均有明显下降，差异无统计学意义（P>0.05）。1年后患者LVEF分数较出院前均明显有提高（P<0.05），且脑心通组较常规治疗组LVEF提高显著（P<0.05）。结论 脑心通对ACS行PCI治疗的患者能有效的改善心绞痛的症状和心电图的缺血表现、减少再发心梗的发生，能起到改善患者的心功能的作用，有利于改善患者的预后。

[关键词] 脑心通；急性冠脉综合征；冠脉介入治疗

[中图分类号] R541.4 [文献标识码] A [文章编号] 1674-0742（2018）10（b）-0103-03

[Abstract] Objective To study the effect of taking ACE on the short-term prognosis of patients with ACS undergoing PCI on the basis of conventional drug therapy for coronary heart disease. Methods A total of 121 patients with ACS who underwent PCI and were enrolled in the Department of Cardiology， Jiangyin People's Hospital from October 2013 to October 2016 were convenient selected and randomly divided into the Naoxintong group and the conventional group. The Naoxintong group was a regular group of coronary heart disease secondary drugs. On the basis of treatment， oral Naoxintong Capsule was adhered to， and the clinical indexes of angina pectoris， electrocardiogram changes， recurrent myocardial infarction， cardiac function， stroke and death were followed up for 1 year. Results There was no myocardial infarction in the Naoxintong group. The total effective rate of angina pectoris in the Naoxintong group was 95.08%， which was significantly higher than that of the conventional group （83.33%）. There was a significant difference between the two groups （χ2=4.353 9，P=0.036 8） （see Table 1）. The total effective rate of electrocardiogram improvement in the Naoxintong group was 98.36% after operation， which was significantly higher than that of the conventional group （86.67%）. There was significant difference between the two groups（χ2=6.008 0，P=0.014 2）. After 1 year of treatment， the cardiothoracic ratio and LVED of the two groups were significantly lower than those before discharge（P<0.05）， but there was no significant difference between the two groups（P>0.05）. After 1 year， the LVEF scores of patients were significantly higher than those before discharge（P<0.05）， and the LVEF of the Naoxintong group was significantly higher than that of the conventional treatment group（P<0.05）. Conclusion Naoxintong can effectively improve the symptoms of angina pectoris and the ischemic manifestations of ECG and reduce the occurrence of recurrent MI. It can improve the heart function of patients and improve the prognosis of patients.

[Key words] Naoxintong； Acute coronary syndrome； Coronary interventional therapy

急性冠状动脉综合征（ACS）起病急、病情危重，患者常可以合并心功能不全，远期的病死率和病残率高。目前PCI治疗的良好疗效和安全性已经得到肯定，但是PCI治疗仅解决了血管狭窄或闭塞的局部问题，不能阻止冠状动脉粥样硬化的进程，也不能达到完全的血管化，且面临着以后支架内再狭窄（ISR）的问题，因此PCI治疗后的二级预防药物治疗不可或缺，该研究主要评价对于ACS行PCI治疗的患者在冠心病常规二级预防的药物治疗基础上坚持服用步长脑心通对其近期预后的影响[1]。该……