通心络对急性心肌梗死急诊PCI患者再灌注损伤的保护性研究

The protective effects of Tongxinluo on myocardium after reperfusion in PCI patients with acute myocardium infarction

目的探讨通心络对急诊PCI患者再灌注心肌损伤的保护机制。方法选自山东大学齐鲁医院急诊科收治的ST段抬高的AMI,并成功实施经皮冠状动脉介入治疗(PCI)的住院患者。随机分成试验组和对照组,对照组给予常规药物治疗;试验组给予常规药物+通心络治疗,疗程2周。分别于入院后即刻、PCI术后1天及术后7天抽取静脉血,测定白细胞介素-6的mRNA水平(IL-6mRNA)及高敏C反应蛋白(hs-CRP)的含量。同时于术后7天、14天测量二维超声心动图,测量左室射血分数(LVEF)。结果两组患者PCI术后1天IL-6mRNA及hs-CRP含量均升高,且两组间无差别,而术后7天IL-6mRNA及hs-CRP含量均较前明显降低(P<0.01),治疗组与对照组相比其含量也降低(P<0.05),左室射血分数(LVEF)较对照组明显改善(P<0.05)。结论通心络具有抗心肌缺血/再灌注损伤,改善PCI术后心肌组织再灌注,抑制炎症反应,改善心功能的作用络。

Objective To study the protective effects of Tongxinluo on myocardium after reperfusion in patients with acute myocardium infarction. Methods The research was performed on the patients with AMI whose initial ECG showed ST segment elevation and the patients who received PCI immediately after onset. All the patients come from Department of Emergency and CP Center of Qilu Hospital. These patients were classified randomly into two groups: control group in which the patients were given routine drug treatment and treatment group in which the patients were given Tongxinluo. The course of treatment is two weeks. We examined the blood IL-6mRNA and hs-CRP levels on the 1st day, 7st day after PCI. We observed the left ventricular ejection fraction (LVEF) in two dimensional echocardiography at the end of the fist week and the second week. Results The day after the PCI IL-6mRNA and hs-CRP in the patients of the two groups increased and there is no difference between the two groups. But seven days later, IL-6mRNA and hs-CRP were decreased much more than before(P<0.01).Compared with control group, in treatment group IL-6mRNA and hs-CRP were also decreased (P<0.05), and LVEF was improved obviously(P<0.05). Conclusions Tongxinluo can prevent myocardial ischemia-reperfusion injury, improve myocardial reperfusion, restrain inflammatory reaction and improve LVEF.