直接PCI联合参麦注射液对急性前壁心肌梗死患者血浆脑钠肽、醛固酮水平和左心室重构的影响  

Effects of combination of Shenmai and primary percutaneous coronary intervention on aldosterone,B-type natriuretic peptide and left ventricular function in patients with acute anterior myocardial infarction

作　　者：马彩艳[1] 童鸿[1] 李小玲[1] 舒哲 张伟[1] 张田杰[1] 

机构地区：[1]浙江省立同德医院心内科,杭州市310012

出　　处：《心电与循环》2014年第3期200-202,206,共4页Journal of Electrocardiology and Circulation

基　　金：浙江省医学会临床科研基金项目(2011ZYC-A07)

摘　　要：目的探讨直接经皮冠状动脉介入(PCI)治疗联合静脉应用参麦注射液对急性前壁心肌梗死患者血浆醛固酮(ALD)、B型脑钠肽(BNP)水平和左心室重构的影响。方法将38例ST段抬高急性前壁心肌梗死行直接PCI患者分为两组:实验组(n=19)和对照组(n=19)。实验组在基础药物治疗基础上,于直接PCI术后予以静脉滴注参麦注射液(50mg/d);对照组单给予基础药物治疗。两组患者于PCI术前、治疗2周、24周后分别抽血检测血浆ALD和BNP,治疗2周、24周后分别行超声心动描记术检测左心室重量(LVM)和室壁运动指数(WMSI)。结果两组患者在治疗2周时实验组ALD、BNP低于对照组,但差异均无统计学意义(均P>0.05);治疗24周时实验组ALD、BNP、WMSI显著低于对照组(均P<0.01),LVEF显著高于对照组(P<0.01)。结论急性前壁心肌梗直接PCI术后应用参麦注射液有利于改善左心室功能。Objective To evaluate the effects of Shenmai injection with primary percutaneous coronary intervention （PCI） on aldosterone, B- type natriuretic peptide （BNP）and left ventricular function in patients with acute anterior myocardial infarction （AAMI）. Methods 38 patients underwent primary PCI for AAMI were randomized divided into Shenmai group（n=19） and control group（n=19）. Al patients received regular therapy. Patients in Shenmai group received Shenmai injection 50mg/d for 15 days on the basis of regular therapy. The serum ALD and BNP were measured before, 2 weeks and 24 weeks after PCI. Echocardiography was performed at 2 weeks and 24 weeks after PCI. Results The levels of ALD and BNP were not significantly different between Shenmai and control groups at 2 weeks, but significantly lower in Shenmai group than control group at 24 weeks. Wal motion index was significantly lower, and left ventricular ejection fraction was significantly higher in Shenmai group than control group at 24 weeks （al P〈0.01）. Conclusion Shenmai injection may improve left ventricular function in patients with AAMI after primary PCI.

关 键 词：ST段抬高心肌梗死 参麦注射液 醛固酮 B型脑钠肽 室壁运动指数 

分 类 号：R542.22[医药卫生—心血管疾病]