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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。
Objective To investigate the protective mechanism of “Xuemaitong Granule” on myocardial ischemia reperfusion injury in patients with acute myocardial infarction undergoing percutaneous coronary intervention. Methods ST-segment elevation and hospitalized patients with acute myocardial infarction who underwent percutaneous coronary intervention were selected. Randomly divided into treatment group and control group, the control group given conventional drug treatment, the treatment group given conventional drugs + collaterals treatment, treatment for 2 weeks. Venous blood was drawn at different times after onset to determine the levels of interleukin 6 mRNA and high-sensitivity C-reactive protein. Simultaneous detection of two-dimensional echocardiography, and observed the incidence of arrhythmia and ECG ST segment resolution after percutaneous coronary intervention in both groups. Results The levels of interleukin-6 mRNA and high-sensitivity C-reactive protein increased after percutaneous coronary intervention in both groups. There was no difference between the two groups. There was no difference between the two groups in arrhythmia and ST segment echocardiography. However, the levels of IL-6 mRNA and high-sensitive C-reactive protein in postoperative 7 days were significantly lower than those before operation (P <0.01). The content of IL-6 mRNA and high sensitivity C-reactive protein in treatment group and control group were also decreased (P <0.05). After 14 days, left ventricular ejection fraction was significantly improved (P <0.05). Conclusions: Xuemaitongtong Granule can prevent myocardial ischemia-reperfusion injury and improve myocardial reperfusion after percutaneous coronary intervention, reduce the expression of inflammatory cytokines and improve cardiac function.