参麦注射液对急诊冠状动脉介入治疗术后心肌缺血／再灌注损伤的干预效应  

Protective effects of Shenmai injection （参麦注射液） on myocardial ischemia reperfusion injury after emergency percutaneous coronary intervention

作　　者：袁敏[1] 郭航远[1] 彭放[1] 裘宇芳[1] 房溶娟[1] 

机构地区：[1]绍兴市人民医院心内科,浙江绍兴312000

出　　处：《中国中西医结合急救杂志》2011年第5期284-286,共3页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：浙江省医学会临床科研基金项目（2008ZYC50）

摘　　要：目的探讨参麦注射液对急诊经皮冠状动脉介入治疗（PCI）术后患者心肌缺血／再灌注（I／R）损伤的干预效应。方法将68例行急诊PCI的急性心肌梗死（AMI）患者随机分为治疗组、对照组，每组34例。在常规治疗基础上，治疗组给予参麦注射液（50ml／d加入5％葡萄糖注射液250ml静脉滴注）治疗，对照组给予等量葡萄糖注射液。观察治疗前和治疗1周后两组患者血一氧化氮（NO）、内皮素（ET）、超氧化物歧化酶（SOD）、超敏C-反应蛋白（hs—CRP）以及血小板膜糖蛋白CD62P、CD63水平变化。结果治疗前治疗组和对照组各项检测指标水平差异均无统计学意义；但治疗1周后，治疗组N0水平（μmol／L）和SOD活性（kU／L）较对照组明显升高（NO：79．12±10．31比71．40±9．59，SOD：141．6±9．5比135．0±10．9，P〈0．01和P〈0．05），而ET（ng／L）水平、hs—CRP（mg／L）及CD62P、CD63的表达率均较对照组有明显下降[ET：54．18±6．78比58．05±7．06，hs—CRP：11．49±3．72比13．54±4．59，CD62P：（2．89±1．13）％比（3．61±1．69）％，CD63：（2．91±1．56）％比（3．74±1．70）％，均P〈0．053。结论参麦注射液可改善PCI术后患者的血管内皮功能，减轻氧自由基损伤和炎症反应，降低血小板活性，能有效地保护I／R损伤的心肌。Objective To explore the protective effects of Shenmai injection （参麦注射液） on myocardial ischemia reperfusion （I/R） injury after emergency percutaneous coronary intervention （PCI）. Methods After emergency PCI, 68 patients with acute myocardial infarction （AMI） were randomly allocated to two groups., treatment group and control group （each n ： 34 cases）. Besides the routine treatment, the patients in treatment group were treated with intravenous drip of 50 ml Shenmai injection in 250 ml of 5% glucose, once a day, and the patients in control group received the same amount of glucose injection respectively for one week. Nitricoxide （NO）, endothelin （ET）, superoxide dismutase （SOD）, hypersensitive C reactive protein （hs-CRP） and platelet membrane glycoprotein CD62P, CD63 were measured before treatment and after one week of treatment. Results There were no significant differences in all parameters between the two groups before treatment. After one week of treatment,the levels of NO （μmol/L） and SOD （kU/L） were significantly higher in the treatment group than those in the control group （NO： 79.12±10. 31 vs. 71. 40±9.59, SOD：141.6±9.5 vs. 135.0±10.9, P〈0.01 and P〈0.05）. However, compared to the control group, the levels of ET （ng/L）, hs-CRP （rag/L）, expression rates of CD62P and CD63 were significantly lower in the treatment group [ET.. 54.18±6.78 vs. 58.0±7.06, hs-CRP.. 11.49±3.72 vs. 13.54±4.59, CD62P.. （2.89±1.13）% vs. （3.61±1.69）%, CD63.. （2.91±1.56）% vs. （3.74±1.70）], all P〈0.05]. Conclusion Shenmai injection can improve the vascular endothelial function,lessen the damage caused by oxygen radicals and inflammatory reaction, decrease the platelet activation, and efficiently protect the myocardium injured by I/R after emergency PCI.

关 键 词：参麦注射液 血管成形术 经腔 经皮冠状动脉 缺血/再灌注损伤 心肌 中西医结合疗法 

分 类 号：R285.6[医药卫生—中药学] R542.2[医药卫生—中医学]