脑心通胶囊对急性心肌梗死患者血管内皮功能及梗死面积的影响

Effect of Naoxintong Capsule on the Vascular Endothelial Function and the Infarct Size of Patients with Acute Myocardial Infarction

目的研究脑心通胶囊对急性心肌梗死(acute myocardial infarction,AMI)患者的血管内皮功能及梗死面积的影响。方法选择AMI患者104例,随机分为脑心通组(36例)、通冠胶囊组(32例)和常规治疗组(36例)。3组均给予常规西药治疗,脑心通组加服脑心通胶囊,通冠胶囊组加服通冠胶囊,疗程均为4周。各组分别检测治疗前后血浆一氧化氮(NO)、内皮素(endothelin,ET)、血管假性血友病因子(von Wille-brand factor,vWF);超声检查肱动脉内径,计算血流介导的血管舒张反应(flow-mediated dilation,FMD)及硝酸甘油介导的血管舒张反应(nitroglycerin-mediated dilation,NMD);评估心电图QRS积分及梗死面积。结果治疗前各组血管内皮功能、心电图QRS积分及梗死面积比较,差异均无统计学意义(P>0.05)。与本组治疗前比较,治疗后脑心通组及通冠胶囊组NO、NMD明显升高,且脑心通组vWF及梗死面积明显降低,差异均有统计学意义(P<0.05)。治疗后与常规治疗组比较,脑心通组及通冠胶囊组NO、FMD、NMD明显升高,ET明显降低(P<0.05);心电图QRS积分及梗死面积亦降低,其中脑心通组差异有统计学意义(P<0.05)。脑心通组在改善NO、NMD、vWF方面明显优于通冠胶囊组(P<0.05)。结论脑心通胶囊可减少AMI患者梗死面积,其机制可能与其改善血管内皮功能有关。

Objective To observe the effect of Naoxintong Capsule（NC） on the vascular endothelial function and the infarct size of patients with acute myocardial infarction（AMI）.Methods One hundred and four patients with AMI were randomly assigned to the NC group（Group A,36 cases）,the Tongguan Capsule group（Group B,32 cases）,and the conventional Western medicine group（Group C,36 cases）.The conventional Western medicine was given to the three groups.NC was additionally given to Group A,and Tongguan Capsule was additionally given to Group B.The therapeutic course for all was 4 weeks.The plasmal nitric oxide（NO）,endothelin（ET）,von Willebrand factor（vWF） were detected in the 3 groups before and after treatment.The inner diameter of brachial artery was examined by ultrasonograph.The flow-mediated dilation（FMD） and the nitroglycerin-mediated dilation（NMD） were calculated.The ECG QRS integral and the infarct size were assessed.ResultsThere was no significant difference in the vascular endothelial function,ECG QRS integral,or the infarct size among the three groups before treatment（P0.05）.Compared with before treatment,NO and NMD obviously increased after treatment in Group A and Group B,while the vWF and the infarct size obviously decreased in Group A,all showing statistical difference（P0.05）.Compared with those in Group C,the NO,FMD,NMD significantly increased and ET obviously decreased in Group A and B after treatment（P0.05）.The ECG QRS integral and the infarct size also decreased,with statistically significant differences in Group A（P0.05）.Better effects on improving NO,NMD,and vWF were obtained in Group A than in Group B（P0.05）.Conclusion NC could reduce the infarct size of AMI patients possibly through improving the vascular endothelial function.