心悦胶囊对PCI后AMI患者心功能的影响及可能机制  

Effect of Xinyue capsule on cardiac function in patients with acute myocardial infarction after percutaneous coronary intervention

作　　者：杜爱玲[1] 刘晨辉 宋吉哲 刘晓红[1] 李敬田[1] 季泰令[1] DU Ailing;LIU Chenhui;SONG Jizhe;LIU Xiaohong;LI Jingtian;JI Tailing(The Affiliated Hospital of Weifang Medical College,Weifang 261031,China)

机构地区：[1]潍坊医学院附属医院

出　　处：《山东医药》2020年第4期17-21,共5页Shandong Medical Journal

基　　金：山东省中医药科技发展计划项目(2017-224);山东省医药卫生科技发展计划项目(2017WS406)

摘　　要：目的观察心悦胶囊对经皮冠状动脉介入术(PCI)后急性心肌梗死(AMI)患者心功能的影响及可能机制。方法将成功急诊PCI治疗的AMI患者130例随机分为观察组66例和对照组64例,对照组给予常规西医药物治疗,观察组在常规西医药物治疗基础上加用中成药心悦胶囊,连服6个月。剔除观察组中断治疗的4例和失访2例、对照组失访2例。观察患者治疗前后的心功能分级、血清NT-proBNP水平及心功能参数(LVEF、LVEDV、LVESV),检测外周血NF-κB、iNOS、NO、TNF-α、IL-10、MDA、SOD,计算心血管不良事件(MACE)发生率。结果两组治疗前心功能Killip分级、LVEF、LVEDV、LVESV、NT-proBNP、NF-κB p65、iNOS、NO、TNF-α、IL-10、MDA、SOD比较差异无统计学意义(P均>0.05)。随访6个月后,两组LVEF、IL-10、SOD高于治疗前(P均<0.05),LVEDV、LVESV和NT-proBNP、NF-κB p65、iNOS、NO、TNF-α、MDA低于治疗前(P均<0.05)。随访6个月后,观察组NT-proBNP、LVEDV、LVESV和NF-κB p65、iNOS、NO、TNF-α、MDA低于对照组(P均<0.05),LVEF、IL-10、SOD高于对照组(P均<0.05)。随访6个月后,观察组MACE发生率低于对照组(P<0.05),两组不良反应发生率比较差异无统计学意义(P>0.05)。结论心悦胶囊可抑制PCI后AMI患者的心室重构、保护心功能,降低MACE发生率,改善患者预后;其机制可能与心悦胶囊调控NF-κB-iNOS-NO信号通路、抑制炎症及氧化应激反应有关。Objective To observe the effect of Xinyue capsule on cardiac function in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods A total of 130 patients with AMI after successful PCI in emergency department were assigned randomly into the treatment group(66 cases)and control group(64 cases).The patients in the control group received routine treatment with Western medicine,and patients in the treatment group received Western medicine combined with Xinyue capsules.Both groups were treated and followed up for 6 months.Four cases were discontinued and 2 cases were lost to follow-up in the treatment group,and 2 cases were lost to follow-up in the control group.We observed the cardiac function grading,serum NT-proBNP level and cardiac function parameters(LVEF,LVEDV,LVESV),and detect the changes of NF-κBp65,iNOS,NO,TNF-α,IL-10,SOD,MDA in the peripheral blood,and the incidence of major adverse cardiovascular events(MACE)before and after the test.Results There were no significant differences in cardiac function Killip classification,LVEF,LVEDV,LVESV,NT-proBNP,NF-κBp65,iNOS,NO,TNF-α,IL-10,MDA or SOD between these two groups before treatment(all P>0.05).After 6 months of follow-up,LVEF,IL-10,and SOD were significantly higher in the two groups than those before treatment(all P<0.05);LVEDV,LVESV and NT-proBNP,NF-κBp65,iNOS,NO,TNF-α,and MDA were significantly lower than those before treatment(P<0.05).After 6 months of follow-up,NT-proBNP,LVEDV,LVESV,NF-κBp65,iNOS,NO,TNF-α,and MDA were significantly lower in the treatment group than in the control group(all P<0.05),and LVEF,IL-10,and SOD were significantly higher than those of the control group(all P<0.05).After 6 months of follow-up,the total incidence of MACE in the treatment group was lower than that in the control group,and the difference was statistically significant(P<0.05),but the incidence of adverse reactions was not statistically different(P>0.05).Conclusion Xinyue capsule can inhibit the ventricular remodeling,prote

关 键 词：急性心肌梗死 心悦胶囊 心功能 NF-κB-iNOS-NO信号通路 

分 类 号：R542.2[医药卫生—心血管疾病]