葛根素注射液对冠心病患者缺血再灌注心肌保护作用及机制

作者	单位
谢瑞芹	河北医科大学第二医院心内科石家庄050000
都军	河北医科大学第二医院心内科石家庄050000
郝玉明	河北医科大学第二医院心内科石家庄050000
崔炜	河北医科大学第二医院心内科石家庄050000
刘凡	河北医科大学第二医院心内科石家庄050000
祖秀光	河北医科大学第二医院心内科石家庄050000
李保华	河北医科大学第二医院心内科石家庄050000
吴金凤	河北医科大学第二医院心内科石家庄050000

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中文摘要:

目的 :探讨葛根素注射液对冠心病心绞痛 (AP)患者缺血再灌注心肌的保护作用及机制。方法 :选择 78例拟行经皮腔内冠状动脉成形术 (PTCA)加支架术治疗的AP患者 ,随机单盲分为常规治疗组 (简称常规组 )和葛根素组 ,在采用常规治疗和术前准备的基础上 ,葛根素组手术前 1周开始加用葛根素注射液2 0 0ml静脉滴注 (每天 1次 ) ,而常规组则采用生理盐水 (NS)代替。观察两组患者在PTCA的球囊扩张过程中发生心绞痛情况及 12导联心电监测提示ST段的变化情况 ;并观察用药前后血中VonWillebrad因子(vWF∶Ag)、一氧化氮 (NO)及内皮素 (ET 1)浓度变化。结果 :与常规组比较 ,葛根素组患者在PTCA过程中出现心绞痛及ST段变化的例数明显减少 ,且血中的vWF∶Ag、ET 1含量明显降低 ,NO含量明显增高。结论 :葛根素注射液对 2～ 3天内发生缺血再灌注的心肌具有保护作用 ,推测其原因之一是其模拟晚期心脏的缺血预处理 ,其机制可能与其能使血中vWF∶Ag及ET 1水平降低、NO水平升高有关。

英文摘要:

Objective: To explore the protective effect and the mechanism of Puerarin Injection (PI) on myocardial ischemia reperfusion in patients with coronary heart disease (CHD) and angina pectoris (AP). Methods: Seventy-eight patients with AP planned to receive the PTCA and stenting treatment were randomly divided and single-blindedly into the conventional group and the PI group. Based on the conventional treatment and pre-operational preparation, the PI group was given 200 ml of PI by intravenous dripping once a day, begining from one week before operation, but to the conventional group, normal saline was given for instead. The condition of AP attack in balloon dilatatory stage of PTCA was observed and change of ST segment of ECG detected by a 12- lead ECG monitor. The blood levels of von Willebrand factor (vWF:Ag), nitric oxide (NO) and endothelin-1 (ET-1) were also observed before and after treatment. Results: As compared with those in the conventional group, number of patients having AP attack and ST segment change in PTCA process was lessened in the PI group, with blood levels of vWF∶Ag and ET-1 obviously lower, and NO content obviously higher than those in the conventional group. Conclusion: PI could protect the myocardium in 2～3 days after ischemia reperfusion, one of the possible reasons is that PI can simulate the late phase of ischemic preconditioning, which may be related to its effect in lowering plasma vWF:Ag and ET-1, and increasing the serum NO content.

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