参麦注射液对STEMI患者直接PCI术后NOS-NO系统活性的影响

目的：观察参麦注射液对ST段抬高型心肌梗死（ST elevation myocardial infarction,STEMI）患者直接经皮冠状动脉支架植入术（Percutaneous coronary intervention,PCI）后NOS-NO系统活性的影响。方法：60例接受急诊PCI治疗的急性STEMI患者,随机分为对照组和观察组（参麦注射液组）各30例,观察PCI术前及术后1、7 d一氧化氮（Nitric ox-ide,NO）含量、内皮型一氧化氮合酶（Endothelial nitric oxide synthase,eNOS）及诱导型一氧化氮合酶（Inducible nitric oxidesynthase,iNOS）活性变化情况;术后冠脉血流及90 min心电图ST段回落率变化。结果：术后NO含量、eNOS活性均下降,iNOS活性增高,但术后1、7 d观察组NO含量、eNOS活性均高于对照组,iNOS活性低于对照组,差异具有统计学意义（P〈0.01）;两组患者术后梗死相关动脉（Infarcted relative artery,IRA）的TIMI 3级血流获得率差异无统计学意义（P〉0.05）,但参麦注射液组90 min时心电图ST段回落率快于对照组（P〈0.05）。结论：参麦注射液可加快急性心梗直接PCI术后心电图ST段回落率,且可能通过影响NOS-NO系统活性改善内皮功能机制而发挥作用。

Effects of Shenmai Injection on NOS-NO System Activity in Patients with STEMI Treated with Direct Percutaneous Coronary Intervention

Obejective： To investigate the effects of Shenmai injection on NOS-NO system activity in patients with ST elevation myocardial infarction（STEMI） treated with direct percutaneous coronary intervention（PCI）.Methods： The patients with STEMI who accepted PCI and were transplanted the stents were randomly divided into treatment and control groups,each group had 30 patients.The treatment group received Shenmai injection.Content of serum Nitric Oxide（NO）,and activities of inducible nitric oxide synthase（iNOS） and endothelial nitric oxide synthase（eNOS） were detected before and after PCI.Coronary blood flow situation and 90 minute ST segment resolution magnitude were studied immediately after PCI.Results： The concentration of NO and the activity of eNOS declined after PCI,but the levels of NO and eNOS in treatment group were significantly higher than in control group 1 and 7 day after operation.Meanwhile,the activity of iNOS increased after PCI,but its activity in treatment group was significantly lower than in control group 1 and 7 day after operation.No significant differences in percentage of TIMI 3 flow achieved in IRAs were found between two groups after PCI,but faster ST segment resolution magnitude was achieved in treatment group.Conclusion： Shenmai injection can faster ST segment resolution magnitude in patients with AMI performed direct PCI,and may play a role by influencing NOS-NO system activity and improving endothelial function mechanisms in patients.