李英 赵丽红

[摘要] 目的 芪苈强心胶囊对急性ST段抬高型心肌梗死经皮冠状动脉介入治疗（PCI）术后患者的心功能及预后的影响。 方法 选取2016年1月～2017年5月河北省直属机关第二门诊部收治的60例急性ST段抬高型心肌梗死患者，均行PCI术，根据治疗方案分为观察组和对照组，每组各30例。术后两组均给予常规西药治疗，在此基础上观察组口服芪苈强心胶囊，对照组口服安慰剂。比较两组患者治疗前及治疗6个月后基质金属蛋白酶-9（MMP-9）、肿瘤坏死因子-α（TNF-α）、一氧化氮（NO）浓度，左室射血分数（LVEF）、左室舒张末内径（LVEDD）、左室后壁厚度（LVPWD）、室间隔厚度（IVSd），以及心脏事件发生情况。 结果 治疗后，观察组患者MMP-9、TNF-α、低于对照组，NO高于对照组差异有统计学意义（P < 0.05）。治疗后观察组患者LVEF明显高于對照组，LVEDD、LVPWD、IVSd低于对照组，差异有统计学意义（P < 0.05）。观察组心脏事件发生率低于观察组（P < 0.05）。 结论 芪苈强心胶囊可促进急性心肌梗死后损伤心肌细胞的修复，改善损伤心肌的收缩能力，促进心肌微循环，抑制梗死后心室重构。

[关键词] 芪苈强心胶囊；急性心肌梗死，ST段抬高型；经皮冠状动脉介入治疗；心功能

[中图分类号] R542.2 [文献标识码] A [文章编号] 1673-7210（2018）02（c）-0137-04

The effect of Qiliqiangxin Capsules on cardiac function and prognosis of patients with ST-segment elevation acute myocardial infarction after PCI

LI Ying ZHAO Lihong

Integrated TCM & Western Medicine Department， the Second Policlinic Directly under the Authority of Hebei Province， Hebei Province， Shijiazhuang 050000， China

[Abstract] Objective To study the effect of Qiliqiangxin Capsules on cardiac function and prognosis of patients with ST-segment elevation acute myocardial infarction after percutaneous coronary intervention （PCI）. Methods From January 2016 to May 2017， 60 patients with ST-segment elevation acute myocardial infarction after PCI in the Second Policlinic Directly under the Authority of Hebei Province were selected and divided into observation group and control group according to treatment， with 30 cases in each group. All patients were treated with conventional western medicine treatment after PCI. In addition to standard therapy， the observation group was treated by Qiliqiangxin Capsules， and the control group were treated by placebo. Before and 6 months after treatment， the matrix metalloproteinase-9 （MMP-9）， tumor necrosis factor alpha （TNF-α） and nitric oxide （NO） concentration were compared. And the left ventricular ejection fraction （LVEF）， left ventricular end diastolic diameter （LVEDD）， left ventricular posterior wall thickness （LVPWD）， interventricular septal thickness （IVSd）， and cardiac events were also compared. Results After treatment， the levels of MMP-9， TNF-α in the observation group were lower than those in the control group， and the leud of NO was higher than that in the control group， with statistically significant difference （P < 0.05）. After treatment， the level of LVEF in the observation group was higher than that in the control group， and the levels of LVEDD， LVPWD， IVSd in the observation group were lower than those in the control group， with statistically significant difference （P < 0.05）. The incidence of cardiac events in the control group was lower than that in the control group （P < 0.05）. Conclusion Qiliqiangxin Capsules is beneficial to the repair of damaged myocardial cells. Besides， it can improve the ability of myocardium contraction， promote myocardial microcirculation andinhibit ventricular remodeling after myocardial infarction.

[Key words] Qiliqiangxin Capsules； Acute myocardial infarction， ST-segment elevation； Percutaneous coronary intervention； Cardiac function

急性心肌梗死（AMI）是临床常见疾病，因心脏血管持续性缺血缺氧所引起心肌坏死，发病急骤，常可危及生命。近年来，随着我国环境、生活水平、居民饮食结构的改变和社会压力的剧增，本病发病率呈明显的上升趋势。ST段抬高型心肌梗死（STEMI）是指心电图具有典型的ST段抬高的一类急性心肌梗死[1-2]，具有典型的缺血性胸痛，持续超过20 min，血清中心肌坏死标志物浓度升高并有动态演变。有报道提示芪苈强心胶囊能够降低醛固酮及血管紧张素Ⅱ的表达水平，扩张外周血管，增强心室收缩力，增加肾血流量，阻滞心功能恶化及抑制心肌重构[3]。本研……