摘要
目的研究麝香保心丸预处理对缺氧复氧心肌细胞的保护作用。方法60例行冠状动脉介入治疗(PCI)的急性心肌梗死患者,根据PCI术前处理方法不同分为A组(31例)和B组(29例)。A组患者PCI术前给予常规处理联合麝香保心丸预处理, B组患者PCI术前仅予以常规处理。观察比较两组入院时及术后3 d的心肌标志物水平;入院时及术后3 d氧化应激指标及炎症指标水平;治疗效果;心功能及N末端脑钠肽前体(NT-proBNP)水平。结果术后3 d,两组患者肌酸激酶(CK)、肌钙蛋白T(cTnT)、肌酸激酶同工酶(CK-MB)水平均低于入院时,差异具有统计学意义(P<0.05);A组患者CK、cTnT、CK-MB水平分别为(94.52±12.02)U/L、(0.24±0.06)ng/ml、(21.01±5.20)U/L,均低于B组的(98.50±13.20)U/L、(0.25±0.10)ng/ml、(22.21±6.20)U/L,但差异无统计学意义(P>0.05)。术后3 d,两组患者血清超氧化物歧化酶(SOD)水平高于入院时, C反应蛋白(CRP)、白细胞介素-6(IL-6)水平低于入院时,差异具有统计学意义(P<0.05);A组患者SOD水平(110.23±8.02)μU/L高于B组(105.30±9.20)μU/L,CRP、IL-6水平分别为(7.23±1.55)mg/ml、(47.30±5.20)pg/ml,低于B组的(8.50±2.20)mg/ml、(51.00±6.20)pg/ml,差异具有统计学意义(P<0.05)。A组患者治疗总有效率96.77%高于B组的79.31%,差异具有统计学意义(P<0.05)。术后12个月随访, A组患者左室射血分数(LVEF)、室壁运动指数(WMI)、NTproBNP水平分别为(58.41±5.20)%、(1.15±0.25)、(68.32±8.02)pg/ml, B组患者LVEF、WMI、NT-proBNP水平分别为(55.80±6.30)%、(1.25±0.35)、(72.33±10.20)pg/ml,比较差异无统计学意义(P>0.05)。结论在心肌梗死患者再灌注治疗前使用麝香保心丸预处理,不显著增加对心肌细胞的保护作用,但可减少心肌耗氧量、减轻炎症反应、提高近期治疗效果,对远期心功能无明显的改善作用。
Objective To study the protective effect of Shexiang Baoxin pill pretreatment on myocardial cells under hypoxia and reoxygenation. Methods A total of 60 patients with acute myocardial infarction who underwent percutaneous coronary intervention(PCI) were divided into group A(31 cases) and group B(29 cases) according to different PCI preoperative treatment. Group A received conventional treatment combined with Shexiang Baoxin pill pretreatment before PCI, and group B received conventional therapy only before PCI.Observation and comparison were made on levels of myocardial markers, oxidative stress indexes and inflammatory indexes at admission and 3 d after operation, therapeutic effect, cardiac function, N-terminal pro-brain natriuretic peptide(NT-pro BNP) between the two groups. Results At 3 d after operation, the creatine kinase(CK), troponin T(c Tn T), creatine phosphatase-isoenzyme MB(CK-MB) in two groups was lower than those at admission, and the difference was statistically significant(P<0.05). The levels of CK, c Tn T and CK-MB were(94.52±12.02) U/L,(0.24±0.06) ng/ml and(21.01±5.20) U/L in group A, which was lower than(98.50±13.20) U/L,(0.25±0.10) ng/ml and(22.21±6.20) U/L in group B, but the difference was not statistically significant(P>0.05). At 3 d after operation, the level of serum superoxide dismutase(SOD) in two groups was higher than those at admission, and levels of C-reactive protein(CRP), interleukin-6(IL-6) was lower than those at admission. Their difference was statistically significant(P<0.05). The level of SOD(110.23±8.02) μU/L in group A was higher than(105.30±9.20) μU/L in group B. The levels of CRP and IL-6 were(7.23±1.55) mg/ml and(47.30±5.20) pg/ml respectively in group A, which was lower than(8.50±2.20) mg/ml and(51.00±6.20) pg/ml in group B. Their difference was statistically significant(P<0.05). The total effective rate of treatment 96.77% in group A was higher than 79.31% in group B, and the difference was statistically significant(P<0.05). At 12 months of follow-up after operation, the left ventricular ejection fraction(LVEF), wall motion index(WMI) and NT-pro BNP were(58.41±5.20)%,(1.15±0.25) and(68.32±8.02) pg/ml respectively in group A, which were(55.80±6.30)%,(1.25±0.35) and(72.33±10.20) pg/ml respectively in group B. The difference was not statistically significant(P>0.05). Conclusion Pretreatment with Shexiang Baoxin pill before reperfusion in patients with myocardial infarction does not increase the repair effect on myocardial cells, but it can reduce myocardial oxygen consumption, reduce inflammation, improve short-term therapeutic effect, and has no significant improvement on long-term cardiac function.
作者
罗芳
韩超
容倩胄
LUO Fang;HAN Chao;RONG Qian-zhou(Department of Internal Medicine-Cardiovascular,Jiangmen People’s Hospital,Jiangmen 529000,China)
出处
《中国现代药物应用》
2019年第21期16-18,共3页
Chinese Journal of Modern Drug Application
关键词
麝香保心丸
预处理
心肌细胞
冠状动脉介入治疗
Shexiang Baoxin pill
Pretreatment
Myocardial cells
Percutaneous coronary intervention
