CAJ | 학술논문

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。
목적：관찰병비교단홍주사액대경피관상동맥직접개입술（ percutaneous coronaryintervention，PCI）치료급성심기경사환자적효과、안전성화궤제。방법진단부합적급성심기경사PCI술후환자수궤분위단홍주사액치료조（단홍조）화대조조，지속치료14 d。치료전후분별측정량조환자혈청심기배사표지물[기산격매（ CK）、기산격매동공매（ CK－MB）、기개단백T（cTnT）]、혈청뇌납태（brain natriureticpeptide，BNP）、내피소－1（endothelin－1，ET－1）농도，심장채초측정좌실사혈분수（ left ventricularejection fraction，LVEF）、심기적종향응변（ longitudinal strain，LS）화경향응변（ radial strain，RS），기록일반림상자료、증상、심전도변화、주원기간사망솔화약물불량반응。결과①공입선71례환자，단홍조36례，대조조35례，량조간기선자료차이무통계학의의。②량조술후3 d혈청심기배사표지물（ CK、CK－MB、cTnT）봉치급치료14 d후BNP、ET－1비교，단홍조균저우대조조（ P＜0．05）。치료후LVEF、LS、RS、ST 단적회락（ ST－segment resolution，STR）≥70％적비례，단홍조균우우대조조（P＜0．05）。단홍조경사후심교통발생솔저우대조조（P＜0．05）。단주원기간사망솔량조간무현저성차이。③단홍조유3례출현경미불량반응，균가내수，무엄중불량반응。결론단홍주사액능구개선급성심기경사PCI술후관맥미순배、감소경사심기、보류좌실수축공능、감소경사후심교통발작。저사작용가능여ET－1수평강저유관。
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.Ser-um myocardial biomarkers, brain natriureticpeptide(BNP), endothelin-1 (ET-1), and left ventricular ejection fraction (LVEF), ra-dial strain (LS), radial strain (RS) were measured.General clinical data, symptoms, ECG changes, hospitalization mortality and ad-verse 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, re-duce myocardial infarction size, reserve LVEF and reduce angina pectoris.The beneficial effects could be related to the lower level of endothelin-1.