急性心肌梗死合并急性心力衰竭患者再灌注后2小时应用西地兰对心脏胶原代谢的影响

doi:10.3969/j.issn.1002-1949.2019.03.006

Chinese Journal of Critical Care Medicine

2019, Vol. 39

Issue (3): 226-232 DOI: 10.3969/j.issn.1002-1949.2019.03.006

Prognostic impact of cedilanid administration after early reperfusion 2 h on collagen metabolism in acute myocardial infarction complicated with acute heart failure patients

Huang Gan-hong, Liu Dong-hua, Xiao Jun-hui, Xu Zhi-qi, Li Li

Department Emergency Medicine, Guangzhou Huadu People′s Hospital, Guangzhou 510800, China

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Abstract Objective To observe the clinical efficacy and safety of cedilanid administration after early percutaneous coronary intervention (PCI) 2 h on left ventricular remodeling and collagen metabolism in acute myocardial infarction complicated with acute heart failure (AMI-AHF) patients. Methods A total of 93 AMI-AHF patients in our hospital from January 2017 to January 2018 were selected and randomly divided into observation group (Cedilanid 0.2 mg + 0.9% saline 20 mL, n=48) and control group (0.9% saline 20 mL, n=45). The hemodynamic parameters, such as pulmonary capillary wedge pressure (PCWP), cardiac index (CI) and stroke volume (SV) were monitored. The left ventricular ejection fraction (LVEF) and short axial shortening rate (FS) were measured by doppler echocardiography. The levels of plasma creatine kinase isoenzyme (CK-MB), myoglobin (Myo), cardiac troponin I (cTnI), B type natriuretic peptide (BNP), carboxy-terminal propeptide of type Ⅰ collagen (PⅠCP) and aminoterminal propeptide of type Ⅲ collagen (PⅢNP) were detected by kits. Results ①Changes of hemodynamic indicators: the indicators of CI, SV increased, PCWP declined after reperfusion, which were significantly obvious between the groups at different time (P<0.05). ②Changes of echocardiography indexes: the indicators of LVEF and FS increased after PCI. LVEF ［(50.48±4.79)% and (954.08±5.12)%］and FS ［(26.85±4.08)% and (28.45±3.97)%］ of observation group were obviously higher than control group at different times after medication of 3 h and 24 h (P<0.05). ③Changes of plasma level: the levels of CK-MB, Myo, cTnI and BNP in both observation and control groups were lower than before administration at medication of 3 h and 24 h (P<0.05). And the levels of Myo［(982.46±458.51) ng/mL］ and BNP ［(460.61±154.95) ng/mL］ in observation group were a little higher than control group (P<0.05). ④Changes of collagen metabolism indexes: the levels of PⅠCP in both observation and control groups were higher than before administration at medication of 24 h (P<0.05). And the levels of PⅠCP ［(24.57±7.34) ng/mL］ and PⅢNP ［(2.68±1.51) ng/mL］ in observation group were lower than control group (P<0.05). Conclusion Early application of cedilanid can improve the left ventricular systolic function and collagen metabolism, It is a safe and effective treatment for reperfused AMI-AHF patients. 

Key words： Acute myocardial infarction (AMI) Acute heart failure (AHF) Low dose cedilanid Early reperfusion Collagen metabolism

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	Huang Gan-hong
	Liu Dong-hua
	Xiao Jun-hui
	Xu Zhi-qi
	Li Li

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Huang Gan-hong,Liu Dong-hua,Xiao Jun-hui, et al. Prognostic impact of cedilanid administration after early reperfusion 2 h on collagen metabolism in acute myocardial infarction complicated with acute heart failure patients[J]. Chinese Journal of Critical Care Medicine, 2019, 39(3): 226-232.

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http://www.cnemergency.org.cn/EN/10.3969/j.issn.1002-1949.2019.03.006 OR http://www.cnemergency.org.cn/EN/Y2019/V39/I3/226

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