脑心通胶囊对急性心肌梗死患者PCI后心肌灌注和血小板活化功能的影响

Effect of Naoxintong Capsule on the Myocardial Perfusion and Platelet Activation Function in Patients with Acute Myocardial Infarction after PCI

目的：观察脑心通胶囊对急性心肌梗死（AMI）患者行经皮冠状动脉介入治疗（PCI）后心肌灌注和血小板活化功能的影响。方法：100例AMI患者采用平行随机抽样法分为对照组与观察组，每组50例。对照组患者给予常规PcI治疗，术前嚼服阿司匹林300mg＋氯吡格雷300mg，术后服用阿司匹林100mg／d＋氯吡格雷75mg／d。观察组患者在对照组治疗基础上（支架释放后）加服脑心通胶囊2～4粒，每日3次。两组疗程均为7d，观察期为1个月。观察并比较两组患者PCI后15min心肌灌注分级（TMPG）情况，治疗前后的血小板活化功能指标[CD62P、CD63及单核细胞血小板聚集体（MPA）阳性表达率1，观察期内主要心血管事件（MACE）和并发症以及不良反应发生情况。结果：治疗后，观察组患者TMPG灌注3级例数占比显著高于对照组，MACE发生率显著低于对照组，差异有统计学意义（P〈0．05）；两组患者并发症发生率和不良反应发生率比较差异无统计学意义（P〉0.05）。治疗前，两组患者cD62P、CD63、MPA阳性表达率比较差异无统计学意义（P〉0．05）；治疗后，两组患者CD62P、CD63、MPA阳性表达率显著低于同组治疗前，且观察组低于对照组，差异均有统计学意义（P〈0．05）。结论：脑心通胶囊可以迅速提高AMI患者PCI后血小板活化功能，改善TMPG灌注情况，降低MACE发生率，且不增加并发症发生率，安全性较好。

OBJECTIVE ： To explore the effect of Buchang naoxintong capsule on the myocardial perfusion and platelet activation fimction in patients with acute myocardial infarction （AMI） after PCI. METHODS： 100 AMI patients were randomly divided into control group and observation group by parallel random sampling, 50 cases in each group. Control group was given conventional PCI, preoperatively chewing 300 mg aspirin＋300 mg clopidogrel, postoperatively taking 100 mg/d aspirin＋75 mg/d clopidogrel. Observation group was additionally treated 2-4 with Buchang naoxintong capsules （after bracket release）, 3 times a day, the treatment course for both groups was 7 d, observation period was 1 month. Infarct-related artery myocardial perfusion grade （TMPG） in 2 groups, platelet activation function indexes [CD62P, CD63 and monocyte platelet aggregation （MPA） positive expression rates] before and after treatment, the incidences of adverse cardiac events （MACE） and complications were observed and compared 15 min after PCI. Meanwhile, the incidence of adverse reactions was recorded. RESULTS： After treatment, the cases of TMPG perfusion grade 3 in observation group were significantly higher than control group, the incidence of MACE was significantly lower than control group, with statistical significance （P〈0.05） ; there was no significant difference in the incidences of complications and adverse reactions in 2 groups （P〉0.05）. Before treatment, there was no obvious difference in CD62P, CD63, MPA positive expression rates in 2 groups; after treatment, CD62P, CD63, MPA positive expression rates in 2 group were significantly lower than before, and observation group was lower than control group, with significant differences （P〈0.05）. CONCLUSIONS： In PCI treatment of AMI patients, Buchang naoxintong capsule can rapidly improve platelet activation functions, TMPG perfusion, reduce the incidence of MACE, with good safety and no increase of complications.