鹿红方对急性心肌梗死PCI术后患者冠状动脉微循环的影响
Effects of Luhong Recipe on coronary microcirculation in patients with acute myocardial infarction after PCI
- 上海中医药大学学报 2021年35卷第3期 页码：12-16
- 作者机构：
1.上海中医药大学附属曙光医院心内科（上海 200120）
- 作者简介：
兰真真，女，在读博士生，主要从事中西医结合防治心血管疾病临床研究
周华，主任医师，博士生导师；E-mail：zhouhuam@hotmail.com
- 基金信息：国家自然科学基金资助项目(81673753)
DOI：10.16306/j.1008-861x.2021.03.003
中图分类号：
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兰真真, 瞿惠燕, 戎靖枫, 等. 鹿红方对急性心肌梗死PCI术后患者冠状动脉微循环的影响[J]. 上海中医药大学学报, 2021,35(3):12-16.
LAN Zhenzhen, QU Huiyan, RONG Jingfeng, et al. Effects of Luhong Recipe on coronary microcirculation in patients with acute myocardial infarction after PCI[J]. Academic Journal of Shanghai University of Traditional Chinese Medicine, 2021,35(3):12-16.
兰真真, 瞿惠燕, 戎靖枫, 等. 鹿红方对急性心肌梗死PCI术后患者冠状动脉微循环的影响[J]. 上海中医药大学学报, 2021,35(3):12-16. DOI： 10.16306/j.1008-861x.2021.03.003.
LAN Zhenzhen, QU Huiyan, RONG Jingfeng, et al. Effects of Luhong Recipe on coronary microcirculation in patients with acute myocardial infarction after PCI[J]. Academic Journal of Shanghai University of Traditional Chinese Medicine, 2021,35(3):12-16. DOI： 10.16306/j.1008-861x.2021.03.003.
摘要
目的：,2,探讨鹿红方对急性心肌梗死经皮冠状动脉介入（PCI）术后患者冠状动脉微循环的影响。,方法：,2,纳入68例急性心肌梗死PCI术后患者，随机分为治疗组和对照组，每组各34例。对照组患者给予常规西药治疗，治疗组患者在对照组治疗基础上加用鹿红方口服，两组治疗疗程均为12周。比较两组患者的心绞痛发病例数、中医证候疗效；于治疗前后检测两组患者的左心室射血分数（LVEF）、左心室收缩末期容积（LVESV）和左心室舒张末期容积（LVEDV），评价两组患者心肌血流灌注成像的总负荷评分（SSS）；检测并比较两组患者的血清血管内皮生长因子（VEGF）水平。,结果：,2,试验过程中，治疗组脱落2例、对照组脱落4例，最终治疗组32例、对照组30例纳入统计分析。①治疗后，治疗组的心绞痛发病例数较治疗前明显减少（,P,<,0.05），且治疗组的心绞痛发病例数少于对照组（,P,<,0.05）；②治疗后，治疗组患者的中医证候疗效总有效率为90.62%，对照组为63.33%，治疗组的中医证候疗效优于对照组（,P,<,0.05）；③治疗后，两组患者的LVESV、LVEDV较治疗前均降低（,P,<,0.05），LVEF均升高（,P,<,0.05），但组间LVESV、LVEDV、LVEF比较差异均无统计学意义（,P,>,0.05）；④治疗后，两组患者的心肌灌注成像SSS较治疗前均降低（,P,<,0.05），且治疗组患者的SSS低于对照组（,P,<,0.05）；⑤治疗后，治疗组患者的血清VEGF水平较治疗前明显升高（,P,<,0.05），且治疗组患者的血清VEGF水平高于对照组（,P,<,0.05）。,结论：,2,鹿红方联合西医常规疗法治疗能有效改善急性心肌梗死PCI术后患者的冠状动脉微循环障碍，增加患者的心肌血流灌注，从而改善患者的临床症状，其机制可能与上调VEGF表达有关。
Abstract
Objective:,2,To explore the effects of Luhong Recipe on coronary microcirculation in patients with acute myocardial infarction after percutaneous coronary intervention(PCI) .,Methods:,2,Sixty-eight patients with acute myocardial infarction after PCI were included and randomly divided into the treatment group and control group, 34 cases in each group.The patients in the control group were treated with the conventional western medicine, and the patients in the treatment group were orally treated with Luhong Recipe based on the treatment for the control group.The treatment course in both groups was 12 weeks.The cases of angina pectoris and the efficacy of Chinese medical syndrome were compared between the two groups.The levels of left ventricular ejection fraction(LVEF), left ventricular end systolic volume(LVESV) and left ventricular end diastolic volume(LVEDV) in both groups were tested before and after treatment, and the summed stress score(SSS) of myocardial perfusion imaging was evaluated in both groups.The level of serum vascular endothelial growth factor(VEGF) in both groups was detected and compared.,Results:,2,During the course of trial, 2 patients in the treatment group and 4 patients in the control group shed.Finally, 32 cases in the treatment group and 30 cases in the control group were included for statistical analysis.①After treatment, the cases of angina pectoris in the treatment group were significantly reduced compared with those before treatment(,P,<,0.05), and the cases of angina pectoris in the treatment group were less than those in the control group(,P,<,0.05) .②After treatment, the total effective rates on Chinese medical syndrome in the treatment group and control group were 90.62% and 63.33% respectively, and the efficacy of the treatment group was better than that of the control group(,P,<,0.05) .③After treatment, the levels of LVESV and LVEDV were decreased in both groups compared with those before treatment(,P,<,0.05), and the level of LVEF was increased(,P,<,0.05) ; but there were no statistically significant differences in the levels of LVESV, LVEDV and LVEF between the two groups(,P,>,0.05) .④After treatment, the SSS of myocardial perfusion imaging was decreased in both groups compared with that before treatment(,P,<,0.05), and the SSS of the treatment group was lower than that of the control group(,P,<,0.05) .⑤After treatment, the level of serum VEGF in the treatment group was significantly increased compared with that before treatment(,P,<,0.05), and the level of serum VEGF in the treatment group was higher than that in the control group(,P,<,0.05) .,Conclusion:,2,Luhong Recipe combined with conventional western medicine can effectively improve the microcirculation disorder of patients with acute myocardial infarction after PCI, increase the myocardial blood flow perfusion, and thus improve the clinical symptoms.Its mechanisms may be related to the up-regulation of VEGF expression.
关键词
急性心肌梗死PCI术后鹿红方冠状动脉微循环VEGF
Keywords
acute myocardial infarctionPCI postoperationLuhong Recipecoronary microcirculationVEGF
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