[1]李瑛,蒋嘉辉,李享,等.益气活血方对急性STEMI患者炎症反应的干预作用[J].西部中医药,2025,38(08):110-114.[doi:10.12174/j.issn.2096-9600.2025.08.20]
　LI Ying,JIANG Jiahui,LI Xiang,et al.Intervention Effects of Invigorating-Qi Activating-blood Prescription on Inflammation in Acute STEMI Patients[J].Western Journal of Traditional Chinese Medicine,2025,38(08):110-114.[doi:10.12174/j.issn.2096-9600.2025.08.20]
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益气活血方对急性STEMI患者炎症反应的干预作用

《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
38
期数:
2025年08期
页码:
110-114
栏目:
临床研究
出版日期:
2025-08-15

文章信息/Info

Title:
Intervention Effects of Invigorating-Qi Activating-blood Prescription on Inflammation in Acute STEMI Patients
作者:
李瑛, 蒋嘉辉, 李享, 宋菲, 王铭
重庆市中医院，重庆 400021
Author(s):
LI Ying, JIANG Jiahui, LI Xiang, SONG Fei, WANG Ming
Chongqing Traditional Chinese Medicine Hospital, Chongqing 400021, China
关键词:
心肌梗死; 急性ST段抬高型; 益气活血方; 白细胞介素18; 外泌体; 罪犯血管
Keywords:
myocardial infarction;  acute ST-segment elevation; invigorating- activating-blood prescription; IL-18; exosomes; culprit artery
分类号:
R256.22
DOI:
10.12174/j.issn.2096-9600.2025.08.20
文献标志码:
B
摘要:
目的观察急性ST段抬高型心肌梗死（ST-segment elevation myocardial infarction，STEMI）患者再灌注治疗后炎症因子白细胞介素18（interleukin-18，IL-18）和不同细胞源性外泌体的浓度变化及益气活血方的干预作用。 方法纳入60例发病12 h以内接受急诊经皮冠状动脉介入治疗（percutaneous coronary intervention，PCI）开通罪犯血管的急性STEMI患者，其中对照组32例，中药干预组28例，对照组给予常规PCI术后药物治疗，观察组在对照组基础上给予益气活血方治疗，两组均治疗90天。两组患者均于PCI术后24、72 h和3个月行空腹抽血，用ELISA法检测血浆IL-18浓度，用流式细胞术检测血浆血小板源性外泌体、白细胞源性外泌体和血管内皮细胞源性外泌体的浓度，并随访患者发病后3个月内的主要不良心血管事件（major adverse cardiovascular events，MACE）和心功能状态。 结果两组患者均从发病-再灌注治疗后24 h开始，炎症因子IL-18、3种不同细胞源性EVs亚型的浓度随时间明显升高，发病-再灌注治疗后3个月的炎症因子浓度最高，差异有统计学意义（P＜0.05）；两组比较，发病-再灌注治疗后3个月中药干预组的IL-18、3种不同细胞源性EVs亚型的浓度明显低于对照组（P＜0.05）；对照组发生MACE事件2例，中药干预组无MACE事件发生。 结论益气活血方能够有效改善STEMI患者的高炎症状态，抑制炎症因子的释放，减少心肌梗死后患者心血管事件的发生。
Abstract:
ObjectiveTo observe the concentrations of different cell-derived exosomes and inflammatory factor IL-18 in STEMI patients after reperfusion therapy and the intervention effects of invigorating-Qi activating-blood prescription. MethodsSixty acute STEMI patients who underwent emergency PCI to open culprit artery within 12 hours after onset were included, among them, there were 32 cases in the control gorup and 28 cases in the herbal intervention group, the control group was treated with conventional drugs after PCI, and the observation group was given invigorating-Qi activating-blood prescription based on Western medicine, and both groups were treated for 90 days. Blood specimen collection was performed in the two groups in 24 hours, 72 hours and three months after PCI, ELISA method was applied to detecte the concentrations of IL-18 in blood plasma, flow cytometry was used to detect the density of plasma platelet-derived exosomes, leukocyte-derived exosomes and endothelial cell-derived exosomes, and to follow MACE and the status of cardiac function within three months after onset. ResultsThe concentrations of IL-18 and three different cell-derived EV subtypes were elevated noticeably with time, and they started 24 hours after onset and reperfusion treatment in the two groups, the concentration of inflammatory factors was the highest three months after onset and reperfusion treatment, and the difference had statistical meaning (P<0.05); the comparison between the two groups showed that the concentrations of IL-18 and three different cell-derived EV subtypes in herbal intervention group were obviously lower than these of the control group three months after onset and reperfusion treatment (P<0.05); there were two cases of MACE in the control gorup and no MACE in herbal intervention group. ConclusionInvigorating-Qi activating-blood prescription could effectively improve the high inflammatory state of STEMI patients, inhibit the release of inflammatory factors and reduce the incidence of cardiovascular events in patients with myocardial infarction.

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备注/Memo

备注/Memo:
李瑛（1987—），女，硕士学位，副主任医师。研究方向：冠心病、心律失常和心力衰竭相关的中西医结合临床及基础研究。重庆市自然科学基金面上项目（cstc2019jcyj-msxmX0662）；重庆市科技局科研机构绩效激励引导专项项目（cstc2018jxjl130038）。
更新日期/Last Update: 2025-08-15