芪苈强心胶囊联合曲美他嗪保护心肌缺血再灌注损伤的作用机制  

Mechanism of Qili Qiangxin Capsule Combined with Trimetazidine in Protecting Myocardial Ischemia-Reperfusion Injury

作　　者：王海涛[1] 黄鹏 张明龙 孔丽丽 马建军[3] WANG Haitao;HUANG Peng;ZHANG Minglong;K0NG Lili;MA Jianjun(Department of Cardiology, The 970th Hospital of The Chinese People' s Liberation Army, Yantai 264002 , Shandong,China;The Department of Cardiology, Yantai Yuding Hospital, Yantai 264000 , Shandong, China;Shandong Yantai 264002, Cancer Center, The 970th Hospital of The Chinese People1 s Liberation Army, Yantai 264002, Shandong,China)

机构地区：[1]中国人民解放军第970医院心内科,山东烟台264002 [2]烟台毓璜顶医院心内科,山东烟台264000 [3]中国人民解放军第970医院肿瘤中心,山东烟台264002

出　　处：《中华中医药学刊》2019年第5期1163-1167,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：山东省自然科学基金项目(ZR2012HM093)

摘　　要：目的:芪苈强心胶囊联合曲美他嗪保护患者心肌缺血再灌注损伤的作用机制。方法:选取100例行急诊经皮冠状动脉介入治疗术患者,随机分为曲美他嗪治疗组,芪苈强心胶囊和曲美他嗪(联合治疗组)。分别于手术前、术后6 h、术后24 h检测肌酸激酶同工酶(CKMB)、心肌肌钙蛋白I(cTnI)、丙二醛(MDA)、超氧化物歧化酶(SOD)。检测患者治疗前后患者血液流变学水平及血管内皮功能变化。结果:实验组和对照组患者术后6 h和术后24 h体内CKMB和cTnI含量显著升高且实验组患者内CKMB和cTnI含量上升更加明显P<0.05)。实验组和对照组患者术后6 h和术后24 h体内MDA含量显著升高,且实验组患者内MDA含量上升更加明显(P<0.05)。实验组和对照组患者术后6 h和术后24 h体内SOD含量显著降低,且实验组患者内SOD含量降低更加明显(P<0.05)。实验组和对照组患者术后1个月心脏指数(CI)、心排血量(CO)、左室射血分数(LVEF)显著升高,且实验组患者内CI、CO和LVEF上升更加明显(P<0.05)。实验组和对照组患者术后1个月左室舒张末内径(LVEDd)显著降低,且实验组患者内LVEDd下降更加明显(P<0.05)。观察组和对照组患者血清mTOR和ET含量在治疗后显著降低,NO和AMPK含量在治疗后显著升高(P>0.05)。对照组血管内皮功能比较,观察组的改善程度更为明显(P<0.05)。与对照组相比,观察组患者心绞痛和心肌梗死患者例数明显减少,观察组的不良结果明显低于对照组(P<0.05)。结论:芪苈强心胶囊联合曲美他嗪可以明显减轻心肌缺血再灌注损伤,具有较好的心肌保护作用,芪苈强心胶囊联合曲美他嗪可以通过激活AMPK信号通路缓解心肌缺血再灌注损伤。Objective: To prevent the mechanism of myocardial ischemia-reperfusion injury in patients with Qili Qiangxin Capsule combined with trimetazidine. Methods: 100 emergency percutaneous coronary intervention patients were treated in hospital. They were randomized to the trimetazidine-treated group(control group), Qili Qiangxin Capsule and trimetazidine combination treatment group(experimental group). Creatine kinase isoenzyme(CKMB), cardiac troponin I(cTnI), malondialdehyde(MDA) and superoxide dismutase(SOD) were measured before surgery, 6 h and 24 h after surgery. Blood rheology and endothelial function changes were measured before and after treatment. Results:The levels of CKMB and cTnI in the experimental group and control gorup were significantly increased 6 h and 24 h after surgery. The CKMB and cTnI levels in the experimental group were significantly increased(P<0.05). MDA content in the experimental group and the control gorup increased significantly at 6 h and 24 h after surgery, and the MDA content in the experimental group increased significantly(P<0.05). The levels of SOD in the experimental group and the control gorup were significantly lower at 6 h and 24 h after surgery, and the SOD content in the experimental group was significantly lower(P<0.05). The heart index(CI), cardiac output(CO) and left ventricular ejection fraction(LVEF) were significantly increased in the experimental group and the control gorup at 1 month after operation, and the CI, CO, and LVEF increased significantly in the experimental group.(P<0.05). The left ventricular end diastolic diameter(LVEDd) was significantly lower in the experimental group and the control gorup at 1 month after operation, and the LVEDd decreased significantly in the experimental group(P<0.05). Serum mTOR and ET levels in the experimental group and the control gorup were significantly decreased after treatment, and NO and AMPK levels were significantly increased after treatment(P>0.05). Compared with the control gorup, the degree of improvement in the experime

关 键 词：芪苈强心胶囊 曲美他嗪 心肌缺血再灌注损伤 

分 类 号：R542.2[医药卫生—心血管疾病]