苦碟子注射液对急性心肌梗死患者心肌保护作用的临床观察

目的　探讨苦碟子注射液对急性心肌梗死 (AMI)患者心肌的保护作用及机制。方法　 10 2例AMI患者随机分为治疗组 (予苦碟子注射液 )和对照组 ,每组各 5 1例。两组患者均接受常规西药治疗及行经皮冠状动脉腔内成形术 (PTCA)。治疗组患者在行PTCA前 7天开始给予苦碟子注射液 4 0ml溶于 5 %葡萄糖注射液 5 0 0ml中静脉滴注 ,1次 d ,连用 4周。结果　治疗组患者治疗后心电图各导联抬高的ST段振幅之和除以ST段抬高导联数的值下降≥ 5 0 %率与完全回落率显著提高 ,梗死部位收缩期室壁增厚率、左心室射血分数显著提高 ,左心室收缩末期容量显著下降 ,核素分布异常节段计数、计分及核素心肌显像缺损范围份数和严重程度积分下降 ,与对照组比较差异有显著性意义 (P <0 .0 1)。结论　苦碟子注射液具有改善冠状动脉血流量 ,增加心肌缺血区灌注的作用 ,对AMI心肌具有保护作用。

Clinical observation on protective effect of Yueanxin Injection on the viable ischemic myocardium in patients with acute myocardial infarction

Objective To explore the protective effect of Yueanxin Injection(YAXI) on the viable myocardium and its mechanism in patients with acute myocardial infarction(AMI).Methods 102 patients with AMI were randomly divided into the YAXI group(n=51) and the control group(n=51).All patients were given the conventional treatment and percutaneous transluminal coronary angioplasty(PTCA).Seven days before treatment with PTCA,the patients of YAXI group were treated with YAXI 40 ml dissolved in 5% glucose 500 ml iv drip qd.The course of treatment in both groups was 4 weeks.Results The number of patients with ∑STI readuction≥50% and complete recovery ST-segment of was larger in treated group than in the control group.The effect of YAXI was observed through comparing the changes of ΔT,LVEF,count and scoring of abnormal nuclide distribution segments,as well as scoring of nuclide filling defect between the two groups.Significant differences were found in comparing the changes in all the aforementioned parameters between the two groups(P< 0.01).Conclusion YAXI has good efficacy in improving coronary blood flow and increasing the myocardial blood perfusion of ischemic area,indicating that it has protective effect on the viable myocardium in patients with AMI.