通心络干预心肌梗死后心室重构的临床多中心研究  

Effects of tongxinluo capsule on cardiac ventricle remodeling after myocardial infarction： a multicentre clinical research

作　　者：陈伟[1] 孙鑫[1] 王文健[2] 傅晓东[2] 符德玉[3] 周京敏[4] 吴以岭 

机构地区：[1]上海中医药大学附属龙华医院急救医学科,200032 [2]复旦大学附属华山医院中西医结合研究所内科 [3]上海中医药大学附属岳阳医院心内科 [4]复旦大学附属中山医院心内科 [5]河北以岭医药研究院

出　　处：《中华医学杂志》2008年第32期2271-2273,共3页National Medical Journal of China

基　　金：上海市科技攻关计划临床医学重点课题资助项目（054119546）

摘　　要：目的观察中药通心络治疗对急性心肌梗死（AMI）后心室重构的影响。方法采用多中心的临床研究方法，将70例AMI患者按双盲法纳入通心络组（35例）和对照组（35例），对照组按指南进行常规药物治疗，通心络组在常规药治疗的基础上，给予通心络胶囊（3粒，3次／日），服用6周。治疗前后用彩色多普勒超声诊断仪分别检测心室结构、心室质量和心室功能等相关指标的变化，同时运用放射免疫法测定两组治疗前后血浆血管紧张素Ⅱ与内皮素1含量的变化。结果通心络治疗6周后，舒张末期室间隔厚度（LVPWTD）、舒张末期左室后壁厚度（LVESD）、左房内径（LAD）改善优于治疗前[（0．90±0．07）cmvs（0．93±0．09）cm、（3．38±0．33）cmvs（3．71±0．19）cm、（3．49±0．50）cmvs（3．21±0．29）cmI及对照组[（0．95±0．08）cm、（3．62±0．46）cm、（3．82±0．30）cm，均P〈0．05]；通心络组EF值改善优于治疗前[（63±7）％vs（52±6）％]及对照组治疗后[（59±8）％，P〈0．05]；通心络组血管紧张素Ⅱ（Ang11）比治疗前明显减少[（55±8）ng／Lvs（79±8）ng／L]，与对照组[（54±8）ng／L]比较差异无统计学意义（P〉0．05）。结论在常规治疗的基础上加用通心络胶囊可在一定程度上干预AMI患者的左心室重构，改善患者的心功能对AMI的预后有积极作用。Objective To investigate the effects of tongxinluo （TXL） capsule on cardiac ventricle remodeling after acute myocardial infarction （AMI）. Methods Seventy AMI patients were randomly divided into 2 equal groups ： conventional therapy group treated with conventional Western therapy and TXL treatment group treated with TXL capsule for 6 weeks in addition to the conventional treatment. Cardiac color ultrasound was conducted before and 6 weeks after the treatment to examine the changes of ventricular structure, mass and function. Radioimmunoassay was used to detect the levels of angiotensin Ⅱ （ Ang Ⅱ ） and endothelin-1 （ ET-1 ）. Results Six weeks later, the left ventricular posterior wall thickness of enddiastolic （LVPWTD） , left ventricular end-systolic dimension（LVESD） , and left atrium dimension （LAD） of the TXL group were 0.93 cm ±0.09 cm, 3.71 cm ±0.19 cm, and 3.21 cm ±0.29 cm respectively, all lower than those before treatment （0.93 cm ±0.09 cm, 3.71 cm ±0. 19 cm, and 3.21 cm ±0.29 cm respectively） and those of the conventional treatment group （0.95 cm±0.08 cm, 3.62 cm ± 0.46 cm, and 3.82 cm ± 0.30 cm） （ all P 〈 0.05 ） , the ejection-fraction （EF） improvement rate of the TXL group was 63%±7%, significantly higher than that before treatment （52% ± 6% ） and that of the conventional treatment group （59% ± 8% , both P 〈 0.05 ） . Conclusion TXL capsule in addition to conventional therapy has a positive effect on the prognosis of AMI via reversing the ventricular remodeling, and improving cardiac function.

关 键 词：心肌梗死 心室重构 通心络胶囊 

分 类 号：R686[医药卫生—骨科学]