应用速度向量成像技术评价丹红注射液的PCI围术期心肌保护作用  

Myocardial protective effect of Danhong Injection evaluated by velocity vector imaging in patients undergoing percutaneous coronary intervention

作　　者：董静[1] 陈韵岱[1] 智光[1] 刘红旭[1,2] 王晶[1] 田峰[1] 周迎[1] 陈劲松[1] 

机构地区：[1]解放军总医院心内科,北京100853 [2]首都医科大学附属北京中医医院

出　　处：《中华医学杂志》2014年第30期2346-2349,共4页National Medical Journal of China

基　　金：首都医学发展科研基金（中医药类）（SF-2009-Ⅰ-12）

摘　　要：目的 应用速度向量成像技术评价丹红注射液对不稳定性心绞痛患者经皮冠状动脉内介入术（PCI）围术期的心肌保护作用.方法 入选2011年3月至2012年3月间解放军总医院接受PCI治疗的不稳定性心绞痛患者120例,完全随机分为2组,丹红组（常规药物治疗＋丹红注射液）60例,在患者接受PCI术前1～3d接受常规药物治疗＋丹红注射液（40 ml＋ 5％葡萄糖注射液/0.9％生理盐水250 ml,静脉滴注）.手术当天PCI穿刺成功即加用丹红注射液1次.术后继续应用4～6d（围术期共应用7d）.对照组给予常规药物治疗.检测术前、术后24 h血清磷酸肌酸激酶同工酶（CK-MB）浓度及肌钙蛋白T（cTnT）浓度;应用速度向量成像技术分析术前、术后的心脏局部室壁运动变化情况.结果 丹红组介入治疗术后CK-MB及cTnT水平显著低于对照组,差异有统计学意义[（18.19±10.23）与（25.12±11.91） μg/L,（0.079±0.007）与（0.132±0.011） μg/L,P＜0.05].PCI术后24 h丹红组局部室壁运动较对照组有明显改善,室间隔心尖段、前壁心尖段、下壁基底段及下壁中间段应变（26.01±7.94与23.25±6.68,20.91±7.55与18.79±8.45,18.10±7.31与16.89±6.05,21.16±6.42与18.37±6.54,P＜0.05）及应变率（1.93±0.79与1.69±0.63,1.86±0.72与1.63±0.68,1.51±0.80与1.25±0.54,1.50±0.45与1.33±0.32,P＜0.05）均优于对照组.结论 PCI围手术期应用丹红注射液可以减轻心肌损伤,改善PCI术后的节段心肌收缩功能.Objective To observe the myocardial protective effect of Danhong Injection evaluated by velocity vector imaging （VVI） in patients with unstable angina pectoris after percutaneous coronary intervention （PCI） and elucidate its possible mechanism.Methods A total of 120 patients were randomized into Danhong （DG,n =60） or control （CG,n =60） groups.The patients in CG group received regular medication according to the guidelines while those in DG group regular medication plus Danhong Injection before and after PCI.During PCI,40 ml Danhong Injection was administrated intravenously.The levels of CK-MB and cTnT were tested before and 24 hours after PCI.And VVI was performed before and 24 hours after PCI.Results After treatment with Danhong injection,the serum level of MB isoenzyme of creatine kinase （CK-MB） and cardiac troponin T （cTnT） in DG were lower than those in CG （18.19 ± 10.23 vs 25.12 ± 11.91,0.079 ± 0.007 vs 0.132 ± 0.011,P ＜ 0.05）.Meanwhile,strain and strain rate of interventricular septum apex,anterior apex,inferior basement and inferior middle segment were better in DG than those in CG （26.01 ±7.94 vs 23.25 ±6.68,20.91 ±7.55 vs 18.79 ±8.45,18.10 ±7.31 vs 16.89 ± 6.05,21.16 ± 6.42 vs 18.37 ± 6.54,P ＜ 0.05 ; 1.93 ± 0.79 vs 1.69 ± 0.63,1.86 ± 0.72 vs 1.63 ± 0.68,1.51 ± 0.80 vs 1.25 ± 0.54,1.50 ± 0.45 vs 1.33 ± 0.32,P ＜ 0.05 respectively）.Conclusion Peri procedual Danhong injection can ameliorate myocardial injury and improve segmental systolic function.

关 键 词：丹红注射液 不稳定心绞痛 经皮冠状动脉内介入术 速度向量成像 

分 类 号：R541.4[医药卫生—心血管疾病]