黄芪保心汤对心肌梗死患者冠脉介入术后心肌再灌注损伤的保护作用

Clinical Effect of Huangqi Baoxin Decoction on Myocardial Reperfusion injury and Related Inflammatory Factors in Patients with Myocardial Infarction after Coronary Intervention

目的观察黄芪保心汤对冠脉介入术后再灌注心肌心型脂肪酸结合蛋白(H-FABPs)及血管内皮生长因子(VEGF)、可溶性细胞黏附因子(SICAM-1)、高迁移率族蛋白1(HMGB1)和相关炎症因子的影响并探讨其机制。方法选择110例心肌梗死患者,采用随机数字表法分为对照组和治疗组各55例,对照组仅西医常规治疗,治疗组在对照组基础上加用黄芪保心汤,疗程12 d。观察患者SICAM-1、HMGB1、H-FABPs、VEGF、肿瘤坏死因子-α(TNF-α)、丙二醛(MDA)、超氧化物歧化酶(SOD)、内皮素-1(ET-1)肌酸激酶同工酶(CK-MB)水平变化。结果与本组治疗前比较,各组治疗后的H-FABPs、CK-MB水平均升高(P <0.05);与对照组同期相比,治疗组治疗后的H-FABPs、CK-MB水平明显降低(P <0.05);与本组治疗前比较,两组治疗后的MDA、ET-1、VEGF水平均降低,SOD水平均升高(P <0.05);与对照组同期比较,治疗组治疗后的MDA、ET-1、VEGF水平明显降低,SOD水平升高(P <0.05);与本组治疗前比较,各组治疗后的SICAM-1水平均降低,TNF-α、HMGB1水平升高(P <0.05);与对照组同期比较,治疗组治疗后的SICAM-1水平明显降低,TNF-α、HMGB1水平升高(P <0.05)。结论黄芪保心汤能降低PCI术后心肌损伤,对心肌具有保护作用,能减轻氧化应激损伤,减轻炎症因子释放,降低血管内皮损伤。

Objective:To observe the effects of Huangqi Baoxin Decoction on H-FABPs,VEGF,SICAM-1,HMGB1 and related inflammatory factors in reperfusion after coronary intervention,and to explore its mechanism.Methods:110 patients were randomly divided into the control group and the treatment group,55 cases in each.The control group was only treated with conventional Western medicine. The treatment group was treated with Huangqi Baoxin Decoction on that basis for 12 days. The level changes of SICAM-1,HMGB1,H-FABPs,VEGF,TNF-α,MDA,SOD,ET-1 and CK-MB were observed. Results:Compared with before treatment,the levels of HFABPs,CK-MB,SOD,TNF-α and HMGB1 in each group increased,while the levels of MDA,ET-1,VEGF and sICAM-1 decreased(P < 0.05);the treatment group was significantly better than the control group. Conclusion:Huangqi Baoxin Decoction can reduce myocardial injury after PCI,protect the myocardium,reduce oxidative stress injury,relieve the release of inflammatory factors,and alleviate vascular endothelial injury.