络脉舒通对急性心肌梗死急诊经皮冠状动脉介入治疗患者再灌注损伤的作用

目的探讨络脉疏通颗粒对急性心肌梗死急诊经皮冠状动脉介入治疗患者再灌注心肌损伤的保护机制。方法选择ST段抬高的并成功实施经皮冠状动脉介入治疗的急性心肌梗死住院患者。随机分成处理组和对照组,对照组给予常规药物治疗,处理组给予常规药物 络脉疏通治疗,疗程2周。分别于发病后不同时间抽取静脉血,测定白细胞介素6mRNA及高敏C反应蛋白的水平。同时检测二维超声心动图,并观测两组患者经皮冠状动脉介入治疗术后心律失常发生率和心电图ST段回落率。结果两组患者经皮冠状动脉介入治疗术后24h白细胞介素6mRNA及高敏C反应蛋白含量均升高,两组间无差别;心律失常及心电图ST段回落率两组间无差别。而术后7天白细胞介素6mRNA及高敏C反应蛋白含量均较术前明显降低(P<0.01),处理组与对照组比较其含量也降低(P<0.05),心律失常及心电图ST段回落率明显降低(P<0.05),14天后左心室射血分数较对照组明显改善(P<0.05)。结论络脉舒通颗粒可抗心肌缺血再灌注损伤,改善经皮冠状动脉介入治疗术后心肌组织再灌注,降低有关炎症因子表达,改善心功能。

The Protective Effects of Luomaishutong Granule on Myocardium After Reperfusion in Patients with Acute Myocardium Infarction

Aim To study the protective effects of luomaishutong granule on myocardium after reperfusion in patients with acute myocardium infarction(AMI).Methods The research was performed on the patients with AMI whose initial ECG showed ST segment elevation and the patients who received percutaneous coronary intervention(PCI)immediately after onset.All patients were classified randomly into two groups:control group in which the patients were given routine drug treatment(50 cases)and treatment group in which the patients were given luomaishutong granule(50 cases).The course of treatment is two weeks.We examined the blood interleukin 6(IL-6)mRNA and high-sensitivity C-reactive protein(hs-CRP)levels on the 1st day,7st day after percutaneous coronary intervention.We observed the left ventricular ejection fraction(LVEF)in two dimensional echocardiography at the end of the fist week and the second week.At the same time we also observed the incidence rate of arrhythmogenesis and degree of ST segment resolution.Results The day after the PCI IL-6 mRNA and hs-CRP in the patients of the two groups increased and there is no difference between the two groups.But seven days later,IL-6 mRNA and hs-CRP were decreased much more than before(P<0.01).Compared with control group,in treatment group IL-6 mRNA and hs-CRP were also decreased(P<0.05),and the incidence rate of arrhythmogenesis and degree of ST segment resolution between the two groups had obvious difference(P<0.05),and LVEF was improved obviously(P<0.05).Conclusions Luomaishutong granule can prevent myocardial ischemia-reperfusion injury,improve myocardial reperfusion,restrain inflammatory reaction and improve LVEF.