舒心丸对急性心肌梗死再灌注后心肌微循环的影响

Shuxin pill on myocardial microcirculation after acute myocardial infarction and reperfusion in rats

目的探讨舒心丸对急性心肌梗死(AMI)溶栓再灌注后,患者体内血浆内皮素(ET-1)、超敏C反应蛋白(hs-CRP)、血栓素A2(TXA2)、一氧化氮(NO)水平、5-HT的变化及其临床意义。方法 86例急性心肌梗死溶栓再灌注患者,均接受西医常规治疗,随机分为2组:治疗组43例,治疗组在西医常规治疗上加用舒心丸,1包/次,3次/d,疗程为15d,对照组43例,分别测出治疗前后ET-1、NO、Hs-CRP、TXA2、5-HT水平的变化。结果治疗前后ET、hs-CRP、TXA2和NO水平治疗组治疗15d后ON水平显著高于对照组(P<0.01),较对照组也明显提高(P<0.05),对照组治疗前后则无明显变化(P>0.05);血清ET-1、hs-CRP、TXA2水平较前明显降低(P<0.01),与对照组明显降低(P<0.01),而对照组治疗后各项指标较前下降,但差异无统计学意义(P>0.05)。结论舒心丸能防治急性心肌梗死溶栓再灌注后心肌微循环障碍,而且安全、价廉,未见明显的毒副作用。其可能机制是通过调节血浆ET-1、NO、Hs-CRP、TXA2水平,促进心肌微循环恢复。

Objective Study on Shuxin pill on acute myocardial infarction（AMI） after Thrombolysis-reperfusion,plasma endothelin of patients（ET-1）,high-sensitivity c-reactive protein（hs-CRP）,thromboxane A2（TXA2）,nitric oxide（NO） levels,changes of 5-HT and its clinical significance.Methods 86 cases of acute myocardial infarction patients with thrombolysis-reperfusion,western medicine in treatment were accepted,randomly divided into 2 groups：group of 43 cases treated,the treatment group on western medicine treatment plus with shuxin pill,1 bag at a time,three times a day,15-day course,control groups in 43 cases,respectively measured before and after treatment with ET-1,NO,Hs-CRP,changes in levels of TXA2,5-HT.Results Before and after treatment with ET,hs-CRP,levels of TXA2 and NO treatment group therapy ON levels significantly higher than the control group after 15 days（P0.01）,than the control group also significantly improve（P0.05）,controlled before and after treatment with no obvious change（P0.05）.Serum levels of ET-1,hs-CRP,TXA2 more significantly reduced（P0.01）,with a control group significantly reduced（P0.01）,the indexes fell earlier after the treatment and control groups,but not statistically significant（P0.05）.Conclusion Shuxin pill in prevention and treatment of acute myocardial infarction after thrombolysis-reperfusion myocardial microcirculatory disorders,and secure,low cost,no significant side effects.Possible mechanism is by adjusting the plasma levels of ET-1,NO,hs-CRP,TXA2 and promoting recovery of myocardial microcirculation.