麝香通心滴丸对急性心肌梗死经皮冠状动脉介入治疗患者炎性因子及心功能的有益作用

目的:探讨麝香通心滴丸对急性ST段抬高型心肌梗死(STEMI)患者急诊经皮冠状动脉介入治疗(PCI)后炎性因子和心功能的影响。方法:选择2015年1月—2017年12月连续82例STEMI并接受急诊PCI的患者,以1∶1随机分为常规治疗组和麝香通心滴丸组(入院后立即口服麝香通心滴丸6丸,次日起2丸/次,每日3次,持续30 d)。测定PCI前及术后7 d血清炎性因子水平及超声心动图左室功能变化。结果:两组患者PCI前血清白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、高敏C反应蛋白(hsCRP)水平相近(P均>0.05),术后7 d时上述指标均有一定程度的降低,但麝香通心滴丸组炎性因子降低幅度较常规治疗组更大(P均<0.05)。两组PCI前左室收缩末期容量(LVESV)、左室舒张末期容量(LVEDV)、左室射血分数(LVEF)无明显差异,术后7 d左心室容量无显著变化,但LVEF较术前明显增高(P<0.05)。术后30 d时,两组患者LVESV和LVEDV均较术前明显减低,LVEF较术前明显增高,且麝香通心滴丸组LVEF改善的程度优于常规治疗组(P<0.05)。结论:急诊PCI可改善STEMI患者的炎性反应及左心功能,加用麝香通心滴丸有助于进一步改善上述作用。

Beneficial effects of She Xiang Tong Xin Dropping Pill on cytokines and left ventricular function in patients with acute myocardial infarction undergoing primary percutaneous coronary intervention

Objective:To explore the effect of She Xiang Tong Xin Dropping Pill on serum cytokine and left ventricular function in patients with acute ST-segment elevation myocardial infarction(STEMI)undergoing primary percutaneous coronary intervention(PCI).Methods:Eighty-two consecutive patients with acute STEMI who received emergency PCI from January 2015 to December 2017 were enrolled,and they were randomly divided into conventional treatment group or She Xiang Tong Xin Dropping Pill group in a 1∶1 ratio,in which the patienrts were administrated orally with 6 pills immediately after admission,followed by 2 pills,three times a day for 30 days.Serum levels of cytokines including interleukin(IL)-6,tumor necrosis factor(TNF)-α,and high-sensitivity C-reactive protein(hsCRP)were assayed,and left ventricular end-systolic(LVESV)and end-diastolic volume(LVEDV)and ejection fraction(LVEF)were determined by two-dimensional echocardiography.Results:In terms of serum levels of IL-6,TNF-a and hsCRP before PCI,there was no statistical difference between the two groups(all P>0.05).They were decreased to a certain extent in both groups at 7 days after operation,but the extent of reduction in serum cytokines was significantly greater in She Xiang Tong Xin Dropping Pill group compared with conventional treatment group(all P<0.05).Before PCI,LVESV,LVEDV and LVEF were similar in the two groups.Seven days after PCI,although left ventricular volumes were unchanged,LVEF was increased(P<0.05).LVESV,LVEDV in both groups were decreased compared with that before operation,and LVEF increased significantly,in addition,the degree of increase in LVEF was significantly greater in She Xiang Tong Xin Dropping Pill group than that in conventional treatment group at 30 days after operation(P<0.05).Conclusions:Emergency PCI has a beneficial effect on inflammation and improvement in left ventricular function for patients with acute STEMI,which could be enhanced by additional use of She Xiang Tong Xin Dropping Pill.