门控心肌灌注显像评价心可舒片治疗冠状动脉慢血流55例临床研究  

Clinical Study on Evaluation of Xinkeshu Tablet(心可舒片) in Treating 55 Patients of Coronary Slow Flow with Gated Myocardial Perfusion Imaging

作　　者：李远[1] 柳岩 肖文良 陈旭光 崔蕴威 王治乾 

机构地区：[1]石家庄市第四医院 [2]河北医科大学第三医院

出　　处：《中医杂志》2017年第24期2119-2123,共5页Journal of Traditional Chinese Medicine

摘　　要：目的评价心可舒片治疗冠状动脉慢血流(CSF)的临床疗效。方法将110例CSF患者随机分为心可舒组和对照组各55例。对照组给予抗心绞痛常规治疗,心可舒组在常规治疗的基础上加用心可舒片,每次1.24 g,每日3次。两组均治疗6个月。治疗前后采用门控心肌灌注显像技术评价心肌受损情况,并采用门控分析软件计算左心室功能参数,测定血浆同型半胱氨酸(Hcy)、肿瘤坏死因子α(TNF-α)、一氧化氮(NO)及内皮素1(ET-1)水平;治疗后判定临床疗效。出院后随访1年,观察不良事件的发生情况。结果心可舒组临床疗效有效率为72.73%,明显高于对照组的50.91%(χ2=5.546,P=0.019)。心可舒组55例患者共发现151个亚段异常,治疗后改善120个,对照组55例患者共发现148个亚段异常,治疗后改善79个,心可舒组受损心肌改善情况明显优于对照组(χ2=4.626,P=0.031)。治疗后心可舒组患者高峰充盈率(PFR)、高峰充盈时间(TPFR)、前l/3充盈时间平均充盈率(MFR/3)及血浆Hcy、TNF-α、ET-1、NO均较对照组改善明显(P<0.05)。两组随访期内均未发生心血管事件。结论心可舒片治疗CSF疗效确切,可改善CSF患者心肌灌注异常和左心室的舒张功能,降低炎性反应。Objective To evaluate the clinical effect of Xinkeshu Tablet in treating coronary slow flow （CSF）. Methods One hundred and ten CSF patients were randomized into a Xinkeshu group and a control group, with 55 patients in each group. The control group was given routine treatment of unti-angina pectoris. The Xinkeshu group was added Xinkeshu Tablet, 1. 24 g each time, 3 times every day in addition to routine treatment of unti-angina pectoris. Both groups were treated for 6 months. Myocardial damage was evaluated with 99Tcm -MIB! gated myocardial perfu- sion imaging （99Tcm-MIBI G-MPI） before and after treatment. Left ventricular function parameters were calculated by gated analysis software. Serum levels of homocysteine （Hcy ） , tumor necrosis factorct （ TNF-c~）, nitric oxide （NO） and endothelin 1 （ET-I） were detected. The clinical effect was determined after treatment. Follow-up was made for 1 year after the patients left hospital. Adverse events were observed. Results The clinical effective rate in the Xinkeshu group was 72.73% , which was higher than 50. 91% in the control group （X2 =5. 546, P =0. 019）. In the Xinkeshu group, 151 subsegmental disorders were found in 55 patients. After treatment, 120 disorders were im- proved. In the control group, 148 subsegmental disorders were found in 55 patients. After treatment, 79 disorders were improved. Myocardial damage improvement in the Xinkeshu group was superior to that in the control group （ X2 = 4. 626, P = 0. 031 ）. After treatment, patients＇ peak filling rate （ PFR）, time of peak filling rate （ TPFR）, mean filling rate of former 1/3 （ MFR/3 ） , as well as serum levels of Hcy, TNF-α, ET-1 and NO in the Xinkeshu group remarkably improved compared with the control group （ P 〈 0. 05 ）. During the follow-up, there was no cardio- vascular event in both groups. Conclusion Xinkeshu Tablet was effective in treating CSF, which might improve CSF patients＇myocardial perfusion disorder and diastolic function of left ventric

关 键 词：冠状动脉慢血流 心可舒片 门控心肌灌注显像 炎性因子 心肌受损 

分 类 号：R541.4[医药卫生—心血管疾病]