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[1]许新民,崔海明,杨靖,等.丹红注射液对急性心肌梗死直接经皮冠状动脉介入术后缺血心肌的保护作用[J].医学研究与战创伤救治(原医学研究生学报),2015,17(05):451-454.[doi:10.3969/j.issn.1672-271X.2015.05.001]
　XU Xin-min,CUI Hai-ming,YANG Jing,et al.Protective effect of Danhong injection on the ischemic myocardium after percutaneous coronary intervention for acute myocardial infarction[J].JOURNAL OF MEDICALRESEARCH —COMBAT TRAUMA CARE,2015,17(05):451-454.[doi:10.3969/j.issn.1672-271X.2015.05.001]
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丹红注射液对急性心肌梗死直接经皮冠状动脉介入术后缺血心肌的保护作用()
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《医学研究与战创伤救治》（原医学研究生学报）[ISSN:1672-271X/CN:32-1713/R]

卷:
第17卷
期数:
2015年05期
页码:
451-454
栏目:
出版日期:
2015-09-30

文章信息/Info

Title:
Protective effect of Danhong injection on the ischemic myocardium after percutaneous coronary intervention for acute myocardial infarction
作者:
许新民1; 崔海明2; 杨靖2; 桂艳萍2; 王家美2; 任雨笙2
1.200402 上海，上海警备区门诊部；2.200003 上海，第二军医大学长征医院心血管内科
Author(s):
XU Xin-min1;  CUI Hai-ming2;  YANG Jing2;  GUI Yan-ping2;  WANG Jia-mei2;  REN Yu-sheng2.
1.The Outpatient Department， Garrison Command of Shanghai， Shanghai 200042， China； 2.Department of Cardiovasology， Changzheng Hospital， Second Military Medical University， Shanghai 200003， China
关键词:
丹红注射液; 急性心肌梗死; 直接经皮冠状动脉介入术; 心肌缺血
Keywords:
Danhong injection;  acute myocardial infarction;  percutaneous coronary intervention;  myocardial ischemia
分类号:
R542.22
DOI:
10.3969/j.issn.1672-271X.2015.05.001
文献标志码:
A
摘要:
目的 观察并比较丹红注射液对经皮冠状动脉直接介入术（percutaneous coronaryintervention，PCI）治疗急性心肌梗死患者的效果、安全性和机制。方法诊断符合的急性心肌梗死PCI术后患者随机分为丹红注射液治疗组（丹红组）和对照组，持续治疗14 d。治疗前后分别测定两组患者血清心肌坏死标志物[肌酸激酶（CK）、肌酸激酶同工酶（CK-MB）、肌钙蛋白T（cTnT）]、血清脑钠肽(brain natriureticpeptide，BNP)、内皮素-1(endothelin-1，ET-1)浓度，心脏彩超测定左室射血分数(left ventricularejection fraction，LVEF）、心肌的纵向应变（longitudinal strain，LS）和径向应变（radial strain，RS），记录一般临床资料、症状、心电图变化、住院期间死亡率和药物不良反应。结果 ①共入选71例患者，丹红组36例，对照组35例，两组间基线资料差异无统计学意义。②两组术后3 d 血清心肌坏死标志物（CK、CK-MB、cTnT）峰值及治疗14 d后BNP、ET-1比较，丹红组均低于对照组(P＜0.05)。治疗后LVEF、LS、RS、ST 段的回落(ST-segment resolution，STR)≥70%的比例，丹红组均优于对照组(P＜0.05)。丹红组梗死后心绞痛发生率低于对照组(P＜0.05)。但住院期间死亡率两组间无显著性差异。③丹红组有3例出现轻微不良反应，均可耐受，无严重不良反应。结论丹红注射液能够改善急性心肌梗死PCI术后冠脉微循环、减少梗死心肌、保留左室收缩功能、减少梗死后心绞痛发作。这些作用可能与ET-1水平降低有关。
Abstract:
Objective To observe and compare the effect， safety and mechanism of Danhong injection (DI) therapeusis in the patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods Eligible patients were randomly divided into DI group and control group. All patients received standard treatment and DI group received DI additionally. Serum myocardial biomarkers， brain natriureticpeptide(BNP)， endothelin-1 (ET-1)， and left ventricular ejection fraction (LVEF)， radial strain (LS)， radial strain (RS) were measured. General clinical data， symptoms， ECG changes， hospitalization mortality and adverse drug reaction were recorded. Results Seventy-one patients were enrolled to DI group (n=36) and control group (n=35). There was no difference between the two groups at baseline. Peak serum CK， CK-MB and cTnT， BNP， ET-1 were lower in DI group (P＜0.05). LVEF， LS， RS and ratio of ST-segment resolution (≥ 70%) in DI group were better than control group (P＜0.05). Incidence of postinfarction angina were lower in DI group (P＜0.05). Adverse reactions of DI were observed rarely and tolerated. Conclusion In addition to guideline-recommended therapies in AMI patients after PCI， DI may improve coronary microcirculation， reduce myocardial infarction size， reserve LVEF and reduce angina pectoris. The beneficial effects could be related to the lower level of endothelin-1.

参考文献/References:

[1]Brosh D，Assail AR，Mager A，et al．Effect of no-reflow during primarypercutaneous coronary intervention for acute myocardial infarc-tion onsix-month mortality[J]．Am J Cardiol，2007，99(4)：442-445．
[2]陈金钟.丹参对心肌梗死的缺血损伤保护作用研究进展[J].东南国防医药，2008，10(1)：35-37.
[3]肖 勇，曹登瑞．丹红对急性冠脉综合征患者介入治疗术后血管内皮功能的影响[J]．西部医学，2010，22(7)：1214-1215．
[4]Akpek M，Sahin O，Sarli B，et al．Acute effects of intracoronary tirofibanon no-reflow phenomena in patients with ST-segment elevated myocardial infarction undergoing primary percutaneous coronary intervention[J].Angiology，2015，66（6）：560-567.
[5]Su Q，Nyi TS，Li L.Adenosine and verapamil for no-reflow during primary percutaneous coronary intervention in people with acutemyocardialinfarction [J].Cochrane Database Syst Rev，2015，5：CD009503.
[6]王 硕，何俗非，翟静波，等.丹红注射液药理作用及临床应用研究进展[J].中国中医药信息杂志，2014，21(3)：128-131.
[7]Liu HT，Wang YF，Olaleye O，et al.Characterization of in vivo antioxidant constituents and dual-standard quality assessment of Danhong injection[J].Biomed Chromatogr，2013，27(5)：655-663.
[8]Ma XJ，Yin SJ，Jin JC，et al.Synergistic protection of Danhong injection and ischemic postconditioning on myocardial reperfusion injury in minipigs [J].Chin J Integr Med，2010，16(6)：531-536.
[9]邓琼梅.丹红治疗冠心病稳定性心绞痛疗效观察[J].中国医药指南，2011，9(23)：142-143.
[10]杨劲松，杨海松.丹红注射液治疗冠心病不稳定型心绞痛疗效观察[J].中国实用医药，2012，7(34)：136-137.
[11]Edvardsen T，Skulstad H，Aakhus S，et al.Regional myocardial systolic function during acute myocardial ischemia assessed by strain Doppler echocardiography [J].J Am Coil Cardiol，2001，37(3)：726-730．
[12]Kukulski T，Jamal F，Herbots L，et al.Identification of acutelyischemic myocardium using ultrasonic strain measurements.A clinical study in patients undergoing coronary angioplasty[J].J Am Coll Cardiol，2003，41(5)：810-819.
[13]Niccoli G，Fracassi F，Cosentino N，et al.No-reflow reversibility：astudy based on serial assessment of multiple biomarkers[J].J Cardiovasc Trans Res， 2013，6(5)：798-807.
[14]王雅婧，张学志，刁 力，等.PI3K／AKt／eNOS信号通路在硫化氢抑制ET-1诱导的心肌肥大中的作用[J].中国循证心血管医学杂志，2014，6(5)：551-557.

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备注/Memo

备注/Memo:
基金项目： 国家自然科学基金青年科学基金项目（81403258）
更新日期/Last Update: 2015-09-20