养心通痹汤对急性心肌梗死患者溶栓治疗后再灌注损伤的保护作用

Protective Effect of Yangxin Tongbi Decoction on Reperfusion Injury in Patients with Acute Myocardial Infarction after Thrombolysis Treatment

目的探讨养心通痹汤对急性心肌梗死患者溶栓治疗后再灌注损伤的保护作用。方法选取我院2011年1月—2014年6月收治的急性心肌梗死患者64例为研究对象,随机分为两组,各32例。对照组给予常规溶栓治疗,观察组在常规溶栓治疗基础上,加用养心通痹汤治疗。结果在治疗后2 h^24 h内,两组患者高敏C反应蛋白(hs-CRP)水平均不断升高,24 h后开始逐渐下降。观察组hs-CRP水平在各个时间点均低于对照组,差异具有统计学意义(P<0.01)。在治疗后2 h^24 h内,两组患者肌酸酶(CK)、肌酸激酶同工酶(CK-MB)及高敏肌钙蛋白T(TNT-HS)水平均不断升高,24 h后开始逐渐下降。观察组CK、CK-MB及TNTHS水平在各个时间点均低于对照组,差异具有统计学意义(P<0.05)。治疗后1 d及治疗后7 d,观察组心肌梗死面积(MIS)均小于对照组,差异具有统计学意义(P<0.01)。治疗后1 d及治疗后7 d,观察组左室射血分数(LVEF)水平高于对照组(P<0.01)。观察组不良心血管事件(MACE)和再灌注心律失常的发生率低于对照组(P<0.05)。结论养心通痹汤可减轻急性心肌梗死患者溶栓治疗后的再灌注损伤,改善左室射血功能,避免不良心血管事件发生。

Objective To investigate the protective effect of Yangxin Tongbi decoction（YTD） on reperfusion injury in patients with a- cute myocardial infarction（AMI） after thrombolysis treatment. Methods Sixty - four patients with AMI, from 2011 January to 2014 June in our hospital, were randomly divided into two groups.. The control group（ n = 32） treated with conventional thrombolytic thera- py, and the treatment group（ n = 32）treated with conventional thrombolytic therapy plus YTD. Results After treatment of 2 h to 24 h, the level of high sensitivity C - reactive protein （hs - CRP） was increased. After treatment of 24 h, the level of hs - CRP started to decline. The levels of hs - CRP at each time point in treatment group were lower than those in control group（ P 〈0. 01）. The levels of creatine kinase （CK）, creatine kinase MB CCK- MB） and troponin T CTnT） HS were increased after treatment of 2 h to 24 h,de- creased gradually after treatment of 24 h. The levels of CK,CK- MB and TnT- HS at each time point in treatment group were lower than those in control group（ P 〈0. 05）. After treatment of 1 day and 7 days, MIS in treatment group was less than that in control group（ P 〈0. 01）. After treatment of 1 day and 7 days, left ventricular ejection fraction （LVEF） in treatment group was higher than that in control group（ P 〈0. 01）. The rates of major adverse cardiac event （MACE） and reperfusion arrhythmia were lower than those in control group（ P 〈0. 05）. Conclusion YTD can reduce reperfusion injury in patients with AMI after thrombolysis treatment, and improve left ventricular ejection function, to avoid the occurrence of adverse cardiovascular events.