丹参、参麦注射液对急性心肌梗死再灌注后脂蛋白相关磷脂酶A的影响  

Effects of Salvia miltiorrhiza or Shenmai Injection on lipoproteinassociated phospholipase A2(Lp-PLA2) in patients with acute myocardial infarction and reperfusion

作　　者：王晓霞[1] 郑艳芬[1] 聂叶廷[1] 韩超[1] 陈小林[1] 

机构地区：[1]广东省江门市人民医院心血管病研究所,广东江门529000

出　　处：《中西医结合心血管病电子杂志》2016年第3期30-32,共3页Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的通过丹参、参麦注射液干预,观察心肌缺血再灌注损伤时脂蛋白相关磷脂酶A2(LP—PLA2)的变化,从而探讨其对心肌缺血再灌注损伤的保护机制。方法选择我院2013年05月-2015年05月急性ST抬高型心肌梗死(STEMI)患者60例,分三组:1.心肌缺血再灌注组20例,2.丹参注射液干预组20例,3.参脉注射液干预组20例。另设对照组20例。所有急性心肌梗死患者入院后均急诊行经皮冠状动脉腔内成形术(PCI),开通闭塞血管。在行PCI前、后即刻、24小时、3天、7天(共5次)抽静脉血2ml于促凝管送检,通过酶联免疫法测定LP—PLA2。丹参注射液干预组于入院后即刻(PCI前)静脉滴注20ml/天,持续7天;参脉注射液干预组静脉滴注40ml/天,持续7天。结果各组Lp-PLA2的变化及分析三组之间总体存在差异。缺血再灌注组和丹参干预组、参麦干预组比较,干预组Lp-PLA2明显降低,P值分别(P=0.031)、(P=0.034),丹参干预组和参麦干预组比较无统计学差异(P>0.05)。结论通过这项研究发现,丹参、参麦注射液能够干预LP—PLA2的变化,从而认为它们可能通过降低炎症介质,达到保护心肌细胞的作用,为中医中药在心肌缺血再灌注损伤的保护方面提供理论依据。Objective To investigate the protective effects and mechanism of Salvia miltiorrhiza and Shenmai injection on the activity level of Lp-PLA2 after percutaneous coronary intervention（PCI） in the patients with acute myocardial infarction（AMI）. Methods A total of 60 consecutive patients with first-time STEMI in Jiangmen First Hospital from May 2013 to May 2015 were selected. AMI patients were randomly divided into three groups： Myocardial ischemic reperfusion（MI / R group, n=20）; ischemic preconditioning group I： MI / R and Salvia miltiorrhiza group（n=20）; ischemic preconditioning group II： MI / R and Shenmai group（n=20） and Sham group（n=20）. Ischemic preconditioning group was given PCI ＋ Salvia miltiorrhiza or Shenmai injection and routine treatment, and Sham group was given PCI ＋ routine treatment. Observe the activity level of Lp-PLA2 at 24h、72h and 7th day time points before and after the operation（a total of five times） by Enzyme linked immunosorbent assay（ELISA）. MI / R and Salvia miltiorrhiza group： Salvia miltiorrhiza injection ip for 7d（ 20 ml/d） before surgery; MI / R and Shenmai group： Shenmai injection ip for 7d（ 40 ml/d） before surgery. Results The changes of Lp-PLA2 in each group and the differences between the three groups were analyzed. Through the comparison of MI / R, I and II groups, Lp-PLA2 was significantly decreased in ischemic preconditioning groups,（PI = 0.031, PII = 0.034）, there was no significant difference between ischemic preconditioning group I and II（P〈0.05）. Conclusion The study found that Salvia miltiorrhiza and Shenmai injection can cause changes in the Lp-PLA2. They may provide a theoretical basis for the protection of traditional Chinese medicine（TCM） on myocardial ischemia reperfusion injury by reducing the inflammatory mediators and protecting the cardiac muscle cells.

关 键 词：心肌缺血再灌注损伤 脂蛋白相关磷脂酶A2 丹参 参麦 

分 类 号：R259[医药卫生—中西医结合]