通心络对急性心肌梗死患者心功能和肿瘤坏死因子-α表达的影响  

Effects of tongxinluo on TNF-α expression and heart function after infarction in patients

作　　者：游敏生[1] 李贤[1] 王彦芝[1] 赵焕芬[1] 岳文芳[1] 陈淑霞[1] 

机构地区：[1]河北省人民医院,河北石家庄050051

出　　处：《中国老年学杂志》2012年第2期231-232,共2页Chinese Journal of Gerontology

基　　金：河北省医学科学研究重点课题计划指令性课题(No.08022)

摘　　要：目的观察通心络对急性心肌梗死患者心功能的变化和肿瘤坏死因子(TNF-α)表达的抑制作用。方法 91例经冠脉造影确诊的急性心肌梗死患者,随机分为常规治疗组和通心络治疗组,常规治疗组46例,口服阿司匹林、美托洛尔(倍他乐克)、单硝酸异山梨醇酯、氯吡格雷、阿托伐他汀等常规治疗,通心络治疗组在常规治疗基础上给予通心络胶囊4粒,每日三次,疗程8 w。治疗前后,心脏超声,放射性核素心室造影检查心功能,ELISA法检测血浆TNF-α水平。结果治疗后,通心络治疗组和常规治疗组患者的心脏超声显示,舒张末期左室腔内径(EDD)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)和射血分数(EF),两组间均无显著性差异(P>0.05),左室收缩功能,LVEF和FS无显著变化(P>0.05),通心络组PER有显著增高(P<0.05)。左室舒张功能PFR和1/3FF显著升高(P<0.05),ELISA法检测患者血浆显示,通心络治疗8 w后,患者血浆TNF-α水平明显降低(P<0.01)。结论 TNF-α与左室功能密切相关,TNF-α的升高影响心功能,通心络有降低TNF-α的作用,可改善心功能。Objective To investigate inhibitory effects of tongxinluo on TNF-α expression and effects of heart function change after infarction in patients. Methods 91 patients with acute myocardial infarction by coronary arteriongraphy were divided into conventional thera- py and toxinluo groups in randomly. Aspirin, metoprolol, isosorbide mononitrate, clopidogrel and atorvastatin were given in conventional thera- py group. 4 pills tongxinluo was added in tongxinluo treatment group with 3 times per week for 8 weeks. Left ventricular structure was meas- ured by echocardiogram and the left ventricular systolic and diastolic function were detected by equilibrium radionuclide angiography （ER- NA）. TNF-α in blood plasma was examined by ELISA. Results There was no difference between two groups in EDD,IVST,VPWT,LVEF and FS. PER, PFR and 1/3FF in tongxinluo group was increased significantly （P 〈 0. 05 ）. TNF-α was lower in blood plasma of tongxinluo group. Conclusions TNF-α has closely correlation with left ventricular function. The TNF-α increasing affects left ventricular func- tion. Tongxinluo can cut down TNF-α level. The left ventricular function is improved after treatment with tongxinluo.

关 键 词：肿瘤坏死因子(TNF-α) 心肌梗死(MI) 心肌纤维化(MF)心肌重塑(MR) 逆转录.聚合酶链反应法(RT-PCR) 

分 类 号：R541.4[医药卫生—心血管疾病]