葛根素对急性心肌梗死患者梗死面积的影响及其机制探讨

目的探讨葛根素对急性心肌梗死患者梗死面积及脂肪酸代谢、炎症反应及斑块稳定性的影响。方法61例急性心肌梗死患者随机分为对照组(30例)和葛根素组(31例)，两组均予常规治疗，葛根素组加用葛根素500mg／d，疗程2周。测定治疗前后血浆游离脂肪酸、基质金属蛋白酶-9(matrix metalloproteinases-9，MMP-9)、C-反应蛋白水平及用Ideker QRS记分法测定梗死面积。结果治疗前血浆自由脂肪酸、MMP-9、C-反应蛋白与梗死面积呈正相关(r=0．43、0．42、0．39，P<0．01)；与治疗前比较，葛根素组自由脂肪酸、MMP-9及C-反应蛋白分别降低30％、41％、23％，梗死面积明显缩小(P<0．01)，对照组无明显变化(P>0．05)。结论葛根素治疗可明显缩小急性心肌梗死面积，可能与降低血浆自由脂肪酸、抑制炎症及稳定动脉粥样硬化斑块有关。

Study on the Effect and Mechanism of Puerarin on the Size of Infarction in Patients with Acute Myocardial Infarction

Objective To observe the effect of puerarin on infarction size, fatty acids metabolism, inflammatory response and atherosclerotic plaque stability in patients with acute myocardial infarction (AMI). Methods Sixty one patients with AMI were randomly divided into two groups, the control group (n=30) and the treated group (n=31). All were treated with conventional treatment, but to the treated group, puerarin injection was given additionally by injecting 500mg per day for 2 weeks. Before and after treatment, blood levels of free fatty acids (FFA), matrix metalloproteinases 9 (MMP 9) and C reactive protein (CRP) were assayed, and the size of infarction was determined by Ideker QRS scoring method. Results Before treatment, the size of infarction was positively correlated to the levels of FFA, MMP 9 and CRP (r = 0.43, 0.42 and 0.39, respectively, all P< 0 01). As compared with those before treatment, after treatment, the three parameters lowered by 30%, 41% and 23%, respectively and the size of infarction significantly reduced in the treated group (P<0 01), while in the control group, no significant change was found (P>0 05). Conclusion Puerarin treatment could significantly reduce the size of infarction in patients with AMI, the mechanism is possibly related with its effects in lowering plasma levels of FFA, inhibiting inflammation and stabilizing atherosclerotic plaque