复方丹参滴丸治疗急性早期心肌梗死42例

Efficacy of compound Danshen drop pill in 42 patients with early acute myocardial infarction

目的:观察复方丹参滴丸(CDDP)对急性心肌梗死(AMI)早期治疗和AMI二级预防的作用。方法:选择确诊AMI患者63例,随机分为治疗组(n=42)和对照组(n=21),治疗组给予口服复方丹参滴丸10粒,tid,对照组给予口服赋型剂量一致的安慰剂,其余治疗完全相同,疗程4个月。观察治疗前后心肌梗死面积(MIA)、室壁运动积分、心脏功能变化、治疗期间主要心血管事件(MACE)和再住院(RH)的发生率,以及治疗后的运动耐量、生活质量总积分(QOL)等。结果:治疗组与治疗前比较MIA减少(P<0.01),室壁运动异常(VWMA)减轻(P<0.01),左室射血分数(LVEF)升高(P<0.01),左室舒张早期和左室舒张晚期血流峰值比(EP/AP)改善(P<0.05),6分钟步行试验(6MT)延长(P<0.05),QOL总分增高(P<0.05),血清细胞凋亡抑制因子减少(P<0.05),主要心血管事件和再住院发生率减少(P<0.05或0.01)。安慰剂对照组治疗前后相关参数无统计学差异。结论:AMI早期加用复方丹参滴丸治疗可明显减少心肌细胞凋亡,减少MIA,减轻VWMA,改善心脏功能,提高运动耐量和生命质量,减少主要心血管事件和再住院发生率,具有较高临床安全性和顺应性,有益于AMI的急性期治疗和AMI后早期二级预防。

Objective： To evaluate early therapeutic efficacy and the secondary prevention effect of compound Danshen drop pill（CDDP） in patients with acute myocardial infarction（AMI）.Methods： Patients with AMI（n=63） were randomly divided into CDDP group（n=42） and control group（n=21）.Patients（test group） received CDDP（10 pills,tid,po） combined with routine treatment,or routine treatment alone（control group） for 4 months.The changes in infarct area,ventricular wall movement scores,cardiac function,major adverse cardiovascular events（MACE）,quality of life（QOL） score,re-hospital,and six-minute-walk（6MT） before and after the treatment were evaluated.Results： CDDP reduced the infarct area（P〈0.01）,the ventricular wall movement anomaly（VWMA,P〈0.01）,improved the ratio of early and late diastolic velocity blood flow（EP/AP,P〈0.05）,increased 6MT（P〈0.05） and QOL scores,attenuated serum mitochondrial damage factor（FAS/Apo-1,P〈0.05 or 〈0.01）,and reduced rate of MACE and re-hospital（P〈0.05 or〈 0.01）.Conclusion： Early use of CDDP significantly reduces myocardial apoptosis,infarct size and VWMA,improves cardiac function,increases 6MT and QOL,and reduces rate of MACE and re-hospital,so this therapy is safe,compliant,and helpful for AMI.