摘要目的 观察中药通心络治疗对急性心肌梗死(AMI)后心室重构的影响.方法 采用多中心的临床研究方法,将70例AMI患者按双盲法纳入通心络组(35例)和对照组(35例),对照组按指南进行常规药物治疗,通心络组在常规药治疗的基础上,给予通心络胶囊(3粒,3次/日),服用6周.治疗前后用彩色多普勒超声诊断仪分别检测心室结构、心室质量和心室功能等相关指标的变化,同时运用放射免疫法测定两组治疗前后血浆血管紧张素Ⅱ与内皮素1含量的变化.结果 通心络治疗6周后,舒张末期室间隔厚度(LVPWTD)、舒张末期左室后壁厚度(LVESD)、左房内径(LAD)改善优于治疗前[(0.90±0.07)cm vs(0.93±0.09)cm、(3.38±0.33)cm vs(3.71±0.19)cm、(3.49±0.50)cm vs(3.21±0.29)cm]及对照组[(0.95±0.08)cm、(3.62±0.46)cm、(3.82±0.30)cm,均P<0.05];通心络组EF值改善优于治疗前[(63±7)%vs(52±6)%]及对照组治疗后[(59±8)%,P<0.05];通心络组血管紧张素Ⅱ(AngⅡ)比治疗前明显减少[(55±8)ng/L vs(79±8)ng/L],与对照组[(54±8)ng/L]比较差异无统计学意义(P>0.05).结论 在常规治疗的基础上加用通心络胶囊可在一定程度上干预AMI患者的左心室重构,改善患者的心功能对AMI的预后有积极作用.

abstractsObjective To investigate the effects of tongxiuluo (TXL) capsule on cardiac ventricle remodeling after acute myocardial infarction (AMI). Methods Seventy AMI patients were randomly divided into 2 equal groups: conventional therapy group treated with conventional Western therapy and TXL treatment group treated with TXL capsule for 6 weeks in addition to the conventional treatment. Cardiac color ultrasound was conducted before and 6 weeks after the treatment to examine the changes of ventricular structure, mass and function. Radioimmunoassay was used to detect the levels of angiotensin Ⅱ ( Ang Ⅱ) and endothelin-1 (ET-1). Results Six weeks later, the left ventricular posterior wall thickness of end- diastolic (LVPWTD), left ventrieular end-systolic dimension( LVESD), and left atrium dimension (LAD) of the TXL group were 0.93 cm ± 0. 09 cm, 3.71 cm ± 0.19 cm, and 3.21 cm±0.29 cm respectively, all lower than those before treatment (0.93 cm±0.09 cm, 3.71 cm ±0. 19 cm, and 3.21 cm±0.29 cm respectively)and those of the conventional treatment group (0.95 cm±0.08 cm, 3.62 cm±0.46 cm, and 3.82 cm±0.30 era) ( all P 0.05 ), the ejection-fraction (EF) improvement rate of the TXL group was 63%±7%, significantly higher than that before treatment (52% ± 6% ) and that of the conventional treatment group (59% ± 8% , both P 0.05 ) . Conclusion TXL capsule in addition to conventional therapy has a positive effect on the prognosis of AMI via reversing the ventricular remodeling, and improving cardiac function.