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目的:探讨步长脑心通胶囊对门诊就医的心肌梗塞患者血清脂联素(APN)、氨基末端脑钠肽前体(NT-proBNP)水平及心功能的影响。方法:选取2013年3月—2016年2月医院收治的87例心肌梗塞患者为研究对象,按数字表法将所有患者随机分为对照组(n=43)和观察组(n=44),两组患者均给予常规西药治疗,观察组患者加服脑心通胶囊1.6 g/次,3次/d,连续治疗4周;超声检查肱动脉内径,心电图检查评估梗死面积及心电图QRS评分,采用电化学发光全自动免疫分析仪检测NT-proBNP水平,ELISA法测定APN水平,放射免疫法测定ET水平,硝酸盐还原酶法测定NO,比较两组患者治疗前后心功能指标、梗死面积、心电图QRS评分及血清ET、NO、APN、NT-proBNP水平变化。结果:治疗后两组患者心功能指标均有明显改善LVDd、LVST显著降低,LVEF显著升高(P<0.05),治疗后观察组LVEF明显高于对照组(P<0.05);与治疗前比较,两组治疗后心肌梗死面积及心电图QRS评分、血清ET、NT-proBNP水平均显著降低(P<0.05),FMD、NMD及血清NO、APN水平均显著升高(P<0.05),治疗后观察组心肌梗死面积及心电图QRS评分、FMD、NMD、NO、ET、APN、NT-proBNP与对照组比较有统计学差异(P<0.05)。结论:步长脑心通胶囊可改善心肌梗塞患者心功能,降低心肌梗死面积,可能与上调脂联素及下调NT-proBNP水平,改善血管内皮功能有关。
Objective: To investigate the effect of naohuan nao tong tong capsule on serum adiponectin (APN), N-terminal pro brain natriuretic peptide (NT-proBNP) level and cardiac function in outpatients with myocardial infarction. Methods: A total of 87 patients with myocardial infarction admitted from March 2013 to February 2016 in our hospital were enrolled in this study. All patients were randomly divided into control group (n = 43) and observation group (n = 44) Patients in the observation group were treated with Naoxintong capsule 1.6g / time 3 times / d for 4 weeks. The diameter of the brachial artery was examined by ultrasonography. The infarct size and ECG QRS score were evaluated by electrocardiogram. The level of NT-proBNP was detected by ELISPOT, the level of APN was measured by ELISA, the level of ET was measured by radioimmunoassay and the level of NO was measured by nitrate reductase method. The cardiac function, infarct size, QRS Score and serum ET, NO, APN, NT-proBNP level changes. Results: After treatment, LVDd, LVST and LVEF were significantly improved in both groups (P <0.05). After treatment, the LVEF in observation group was significantly higher than that in control group (P <0.05). Compared with those before treatment (P <0.05). The levels of FMD, NMD, serum NO and APN in both groups were significantly increased after treatment (P <0.05). After treatment, the area of myocardial infarction and QRS score of electrocardiogram, ET and NT- Myocardial infarction area and ECG QRS score, FMD, NMD, NO, ET, APN and NT-proBNP in the observation group were significantly different from those in the control group (P <0.05). CONCLUSION: Buchang Naoxintong capsule can improve cardiac function and myocardial infarct size in patients with myocardial infarction, which may be related to upregulation of adiponectin, down-regulation of NT-proBNP and improvement of endothelial function.