银杏内酯B对急性心肌梗死患者血运重建后心室壁运动的影响  

Effects of ginkgolide B on the ventricular wall motion of patients with acute myocardial infarction after revascularization

作　　者：江家华 邓庆华 高于英 

机构地区：[1]云南省中西医结合医院,云南昆明650051

出　　处：《中成药》2018年第2期294-299,共6页Chinese Traditional Patent Medicine

摘　　要：目的明确银杏内酯B处理急性心梗患者血运重建后心室壁运动及收缩功能的效应。方法本研究共纳入80例行血运重建的急性心梗患者,随机分为对照组和银杏内酯B处理组,每组患者为40例,2组患者分别在常规西药治疗的基础上以安慰剂及银杏内酯B进行处理,时间为3个月。对两组患者在血运重建后的2周及3月时间点分别采用多巴酚丁胺负荷心脏超声心动图评价心功能、正常心肌百分比、室壁运动、纵向峰值应变力及应变率峰值,并比较这些指标之间的差异。结果银杏内酯B处理能够在2周时相比于对照组显著提高左室射血分(66.06±8.39 vs.60.45±13.35,P<0.05)和正常心肌百分比(86.88±8.76 vs.79.84±12.25,P<0.01),其对室壁运动有一定程度的降低,但差异无统计学意义(P>0.05)。对于左室前壁心梗的患者,银杏内酯B处理在纵向峰值应变力及纵向峰值应变率峰值上在2周时间点上相比于对照组,及在基底段及中间段及心尖段上相比于对照组负值的增加程度更为明显(P<0.05,P<0.01);而在3月时银杏内酯B处理纵向峰值应变力在心尖段相比于对照组仍有显著的差异(P<0.05)。对于左室下壁心梗的患者,在纵向峰值应变力上,银杏内酯B处理组在2周和3月时相比于对照组,分别在基底段及心尖段上负值的增加程度更为明显(P<0.05);而在纵向峰值应变率峰值上,银杏内酯B处理在2周时相比于对照组在基底段及中间段有显著差异(P<0.01),在3月的时间点上,银杏内酯B处理组在基底段相比于对照组有显著的差异(P<0.05)。结论银杏内酯B对于行血运重建后急性心梗患者的心室壁运动及收缩功能有改善效应。AIM To investigate the role of ginkgolide B on the ventricular wall motion and systolic function in acute myocardial infarction（ AMI） patients after their revascularization. METHODS A total of 80 cases of AMI patients who underwent revascularization were divided into control group and ginkgolide B treatment group,with 40 patients per group. The two groups of patients both treated basically with routine western medicine were dosed with either placebo or ginkgolide B for 3 months. The cardiac function,normal myocardial percentages,ventricular wall motion,longitudinal peak systolic strain（ LPSS） and rate（ LPSSR） were evaluated by dobutamine stress echocardiography and these indexes were compared. RESULTS Compared to the control group,left ventricular ejection fraction（ LVEF）（ 66. 06 ± 8. 39 vs. 60. 45 ± 13. 35,P〈0. 05） and normal myocardial percentages（ 86. 88 ±8. 76 vs. 79. 84 ± 12. 25,P〈0. 01） were significantly improved at the 2 ndweek in ginkgolide B treatment group,but no significant difference on ventricular wall motion was observed between the two groups（ P〈0. 05）. For the patients with anterior wall AMI,the minus LPSS and LPSSR at basal,middle and apex segment were significantly improved at the 2 ndweek in ginkgolide B treatment group compared to the control group（ P〈0. 05,P〈0. 01）.Moreover,LPSS at apex segment was significantly improved at the 3 rdmonth in ginkgolide B treatment group compared to the control group（ P〈0. 05）. For the patients with inferior wall AMI,minus LPSS at basal and apex segment were significantly improved at the 2 ndweek and the 3 rdmonth in ginkgolide B treatment group compared to the control group（ P〈0. 05）,whereas minus LPSSR at basal and middle segment at the 2 ndweek and basal segment at the 3 rdmonth were significantly improved in ginkgolide B treatment group compared to the control group（ P〈0. 05）. CONCLUSION Revascularized AMI patients treated with ginkgolide B can expect an improved ventricular wall motion.

关 键 词：银杏内酯B 急性心梗 血运重建 心室壁运动 

分 类 号：R287[医药卫生—中药学]