四逆汤对经皮冠状动脉腔内成形术心肌顿抑的保护作用  

The protective effects of Sinitang on stunning myocardium following PTCA

作　　者：苏建文[1,2] 林曙光 吴伟康[1,2] 陈鲁源 

机构地区：[1]广东省心血管病研究所 [2]中山医科大学中西医结合研究所

出　　处：《中国药学杂志》1997年第12期740-743,共4页Chinese Pharmaceutical Journal

摘　　要：目的：评价四逆汤对冠心病患者行经皮冠状动脉腔内成形术（ｐｅｒｃｕｔａｎｅｏｕｓｔｒａｎｓｌｕｍｉｎａｌｃｏｒｏｎａｒｙａｎｇｉｏｐｌａｓｔｙ，ＰＴＣＡ）后顿抑心肌功能的保护作用。方法：将４６名拟行ＰＴＣＡ术的冠心病患者随机分为对照组（ｎ＝２３）和服药组（ｎ＝２３）进行观察。结果：单纯ＰＴＣＡ术后出现心功能低下的现象；但服用四逆汤能够使术后心功能比术前显著地提高（均为Ｐ＜０．０１）：左心室前壁收缩期室壁增厚率（ＰＳＷＴＡ）升高３８％（０．３６±０．０４ｖｓ０．５０±０．０７），左心室后壁收缩期室壁增厚率（ＰＳＷＴＰ）升高５７％（０．３５±０．０３ｖｓ０．５５±０．０６），左心室射血分数（ｌｅｆｔｖｅｎｔｒｉｃｕｌａｒｅｊｅｃｔｉｏｎｆｒａｃｔｉｏｎ，ＬＶＥＦ）升高１２％（０．３９±０．０１ｖｓ０．４４±０．０２），每搏输出量（ＳＶ）升高１７％（１８．５３±０．８８ｖｓ２１．８４±１．０９），每分输出量（ｃａｒｄｉａｃｏｕｔｐｕｔ，ＣＯ）升高１５％（１．３７±０．０６ｖｓ１．５６±０．０８）。结论：四逆汤能改善ＰＴＣＡ术后缺血心肌的局部收缩功能和整体功能，利于心肌顿抑状态的解除。OBJECTIVE: To study the protective effects of Sinitang (Chinese traditional medicine decoction) on stunning myocardium following percutaneous transluminal coronary angioplasty (PTCA). METHOD: Fortysix patients treated with PTCA were randomly divided into control group (n=23) and Sinitang group (n=23). RESULTS: The cardiac functions of postPTCA without Sinitang were lower than those of prePTCA, but the cardiac functions of postPTCA with Sinitang were more improved than those of prePTCA. The percentages of systolic wall thickness of anterior wall (PSWTA) were increased by 38% (0.36±0.04 vs 0.50±0.07, P<0.01), the percentages of systolic wall thickness of posterior wall (PSWTP) were increased by 57% (0.35±0.03 vs 0.55±0.06, P<0.01). The stroke volumes (SV) were increased by 17% (18.53±0.88 vs 21.84±1.09, P<0.01), the left ventricular ejection fractions (LVEF) were increased by 12% (0.39±0.01 vs 0.44±0.02, P<0.01), and the cardiac outputs (CO) were increased by 15% (1.37±0.06 vs 1.56±0.08, P<0.01). CONCLUSION: Sinitang can significantly protect ischemic myocardium of PTCA from stunning injury.

关 键 词：心肌顿抑 四逆汤 冠状动脉 腔内成形术 

分 类 号：R654.205[医药卫生—外科学] R259.422[医药卫生—临床医学]