摘要
目的评价宽心合剂辅助直接经皮冠状动脉介入术(PCI)治疗急性心肌梗死(AMI)的心肌保护作用。方法入选成功接受直接PCI治疗的急性前壁心肌梗死患者60例,随机分为宽心合剂组和常规PCI对照组(常规对照组),每组30例。宽心合剂组在直接PCI及常规药物治疗基础上于再灌注治疗成功后予宽心合剂20ml/d,口服,随访3个月。于术前及术后1、8、24、48h及7d分别取静脉血3ml,测定血清肌酸激酶同工酶(CK-MB)、血清总超氧化物歧化酶(T-SOD)及血清丙二醛(MDA)水平。于术前及术后2h记录心电图,分析ST段抬高幅度与ST段恶化的发生率。并于术后2d及3个月分别行心脏超声检查以评价心功能。结果宽心合剂组较常规对照组术前心电图(ECG1)ST段抬高幅度、术后2h心电图(ECG2)ST段抬高幅度、ST段下降幅度及ST段恶化率比较,差异无统计学意义。宽心合剂组血清CK-MB水平较常规对照组术后8h明显升高,差异有统计学意义(P<0.05);宽心合剂组血清MDA水平较常规对照组术后1h明显升高,差异有统计学意义(P<0.05);宽心合剂组血清T-SOD水平较常规对照组术后8h明显降低,差异有统计学意义(P<0.05)。心脏超声检查术后2d两组患者各指标差异均无统计学意义(P<0.05),术后3个月宽心合剂组患者LVEDV、LVESV较常规对照组显著减小,LVEF明显升高,差异均有统计学意义(P<0.05)。结论宽心合剂对AMI发病早期急性缺血-再灌注损伤心肌具有心肌保护作用,减轻心肌细胞氧自由基过氧化损伤可能是其作用机制之一。
Objective To evaluate the myocardial protection of Kuanxin Herbal Mixture in aiding percutaneous coronary intervention （PCI） to treat acute myocardial infarction （AMI）.Methods Sixty AMI patients receiving PCI therapy were randomized into groups Kuanxin,control （conventional PCI）,30 in each.Kuanxin group given oral Kuanxin Herbal Mixture （20 ml/d） after successful reperfusion therapy based on direct PCI and conventional drug treatment,follow-up being 3 months.Venous blood （3 ml） was taken before operation,at hours 1,8,24,48,on days 7 after operation,respectively,to detect the levels of serum creatine kinase isoenzyme （CK-MB）,serum superoxide dismutase （T-SOD） and malondialdehyde （MDA）.ECG recording was performed before operation,2 h after,to analyze ST-segment elevation range and the incidence of ST-segment deterioration.Cardiac ultrasound examination was conducted to evaluate cardiac function 2 d,3 months after operation.Results There was not significant difference between 2 groups in pre-operation ECG1 ST-segment elevation range,post-operation 2-hour ECG2 ST-segment elevation range,descent range and deterioration.CK-MB level was higher in Kuanxin group than in control 8 h after operation,the difference was significant.MDA level was higher in Kuanxin group than in control 1 h after operation,but T-SOD level lower 8 h after operation,the difference was significant.No significant difference was noted in all indicators of cardiac ultrasound between 2 groups 2 d after operation.LVEDV,LVESV reduced,LVEF increased in Kuanxin group 3 months after operation as compared with control,the difference was significant.Conclusion Kuanxin Herbal Mixture has protective effect on acute ischemia-reperfusion injured myocardium.Its reduction of myocardial oxygen free radical oxidative damage may be one of the mechanisms.
出处
《中国全科医学》
CAS
CSCD
北大核心
2010年第9期932-935,共4页
Chinese General Practice
基金
河北省中医药管理局科学研究计划项目(2007086)
关键词
心肌梗塞
血管成形术
经腔
经皮冠状动脉
治疗
临床研究性
Myocardial infarction
Argioplasty transluminal percutaneous coronary
Therapies
imestigational
