灯盏花素注射液对急性ST段抬高性心肌梗死急诊PCI 术后心力衰竭患者神经内分泌激素、血清 MMP －9及 MPO 的影响

摘要

Objective It is to observe the effect of Breviscapine injection on neuroendocrine hormones , serum levels of ma-trix metalloproteinases 9 ( MMP-9) and myeloperoxidase ( MPO) in the heart failure patients with acute ST -elevation myo-cardial infarction (STEMI) after emergency PCI.Methods 102 heart failure patients with STEMI after emergency PCI were randomly divided into observation group (51 cases) and control group (51 cases).The control group was given conventional western medicine treatment , on the basis of therapy in the control group ,the observation group was treated with Breviscapine injection.Both groups were treated for 14 days.The changes of neuroendocrine hormones and serum levels of MMP -9, MPO, exercise tolerance, heart function, quality of life before and after treatment were observed .Results After treatment the levels of serum norepinephrine ( NE ) , adrenocorticotropic hormone ( ACTH ) and cortisol ( Cor ) , angiotensinⅡ ( AngⅡ) were significantly reduced in both groups (P<0.05), and the decrease in the observation group were more significant than that in the control group (P<0.05);6 minutes walk test (6 MWT) distance, left ventricular ejection fraction (LVEF) and cardi-ac function NYHA classification , Minnesota heart failure to possess the ability to improve the quality of life scale ( MLHFQ) scores were significantly improved in both groups , and the improvements in observation group were better than that of control group (P<0.05).Conclusion Breviscapine injection can significantly improve cardiac function , inhibit left ventricular re-modeling and improve exercise tolerance and quality of life in the heart failure patients with STAMI after emergency PCI , its mechanism may be related to decrease serum neuroendocrine hormones secretion and levels of MMP -9,MPO.%目的：观察灯盏花素注射液对急性ST段抬高性心肌梗死（ STEMI ）急诊PCI术后心力衰竭（HF）患者神经内分泌激素、血清基质金属蛋白酶－9（MMP－9）及髓过氧化物酶（ MPO）的影响。方法将102例STEMI急诊PCI术后HF患者随机分为观察组51例和对照组51例，对照组给予常规西医治疗，观察组在对照组治疗基础上加用灯盏花素注射液治疗，2组疗程均为14 d。观察2组治疗前后血清神经内分泌激素、MMP－9及MPO水平和运动耐量、心功能状态、生活质量的变化情况。结果2组治疗后血清去甲肾上腺素（NE）、促肾上腺皮质激素（ ACTH）、皮质醇（ Cor）、血管紧张素Ⅱ（ AngⅡ）和MMP－9、MPO水平均显著降低（P均＜0．05），且观察组上述指标水平均明显低于对照组（P均＜0．05）；2组治疗后6 min步行试验（6MWT）距离、左室射血分数（LVEF）、心功能NYHA分级、明尼苏达心力衰竭生活质量量表（MLHFQ）评分均明显改善（P均＜0．05），且观察组上述指标改善情况均明显优于对照组（P均＜0．05）。结论灯盏花素注射液能够显著改善STEMI急诊PCI术后HF患者心功能状态，抑制左室重构，提高运动耐量及生活质量，其机制可能与降低血清神经内分泌激素及MMP－9、MPO水平有关。