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苏国海,刘丽,孟庆华,王磊.参附注射液对急性心肌梗死介入治疗患者血浆脑钠素和Ⅲ型前胶原N末端肽的影响[J].中国中西医结合杂志,2005,(5):422-424
参附注射液对急性心肌梗死介入治疗患者血浆脑钠素和Ⅲ型前胶原N末端肽的影响
Effect of Shenfu Injection on Brain Natriuretic Polypeptide and Aminoterminal Peptide of Precollagen Type Ⅲ in Patients with Acute Myocardial Infarction during Intervention Treatment
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DOI:
中文关键词:  参附注射液  急性心肌梗死  脑钠素  Ⅲ型前胶原N末端肽
英文关键词:Shenfu injection  acute myocardial infarction  brain natriuretic polypeptide  aminoterminal peptide of precollagen Ⅲ
基金项目:
作者单位
苏国海 山东大学济南临床学院济南市中心医院心内科 济南250013 
刘丽 山东大学济南临床学院济南市中心医院心内科 济南250013 
孟庆华 山东大学济南临床学院济南市中心医院心内科 济南250013 
王磊 山东大学济南临床学院济南市中心医院心内科 济南250013 
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中文摘要:
      目的观察参附注射液对急性心肌梗死(acutemyocardialinfarction ,AMI)经皮冠脉内介入治疗(percutaneouscoronaryintervention ,PCI)患者心功能和心肌纤维化指标的影响。方法将93例AMI介入治疗患者,随机分为治疗组(47例,在PCI基础上加用参附注射液40ml静脉注射,每天1次,共7天)和对照组(46例,单用PCI治疗)。检测两组患者入院时、发病2 4h及第7天的血浆脑钠素(brainnatriureticpolypeptide,BNP)、Ⅲ型前胶原N末端肽(aminoterminalpeptideofprocollagentypeⅢ,NPⅢ)水平。结果治疗组与对照组比较PCI术后梗死相关血管前向血流TIMI 3级比例差异无显著性,发病2 4h两组BNP浓度均较入院时明显升高(P <0 . 0 1) ,对照组明显高于治疗组(P <0 .0 1) ;第7天治疗组血浆BNP浓度与入院时比较已无明显差异(P >0 . 0 5) ,但对照组仍显著高于治疗组(P <0 . 0 1) ,而且仍较入院时显著升高(P <0. 0 1)。两组在入院时及发病2 4h血浆NPⅢ浓度无明显差异;第7天治疗组血浆NPⅢ浓度较入院时有所升高,但差异无显著性,而对照组较入院时明显升高(P <0 . 0 5) ,也较治疗组显著升高(P <0 .0 5)。结论早期应用参附注射液对心肌缺血再灌注损伤有保护作用,并能减轻胶原损伤的程度,改善患者心功能、抑制心肌纤维化。
英文摘要:
      ObjectiveTo investigate the effect of Shenfu injection (SFI) on indexes of heart function and myocardial fibrosis in patients with acute myocardial infarction (AMI) treated by percutaneous coronary intervention (PCI). MethodsNinety-three AMI patients treated by PCI were randomly divided into two groups, 47 in the treatment group (treated by PCI plus 40 ml SFI intravenous injection, once a day for 7 days) and 46 in the control group (treated by PCI only). Levels of brain natriuretic poly peptide (BNP) and aminoterminal peptide of precollagen type Ⅲ (NPⅢ) were measured at different time points, i.e. immediately after admission (T1), and at 24th hour (T2) and 7th day (T3) after AMI onset in the two groups. ResultsThe proportion of TIMI 3 grade of front blood flow in AMI related vessels after PCI was insignificantly different in the two groups. The concentration of BNP of T2 was significantly higher than that of T1 in the two groups (P<0.01), and it was higher in the control group than that in the treatment group (P<0.01),while at T3, it was insignificantly different in the treatment group to that of T1(P>0.05), but in the control group, it was still significantly higher than that in the treatment group and that of T1 (P<0.01). The levels of NPⅢ in the two groups were similar at T1 and T2(P>0.05). At T3, it showed an increase in the treatment group, but with no significant difference (P>0.05) as compared with that at T1, but in the control group did markedly increase and showed significant difference as compared with that of T1 and that in the treatment group at T3 (P<0.05). ConclusionEarly applying of SFI can protect myocardium from ischemia/reperfusion injury after AMI, ameliorate the degree of injury, improve heart function of patients and prevent myocardial fibrosis.
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