The Experimental And Clinical Research Of QXL To The Ventricular Remodeling After Acute Myocardial Infarction

In recent years, interfering Ventricular Remodeling (VR) after Acute Myocardial Infarction (AMI) has been the hot Point which has been paid more attention in the scope of coronary atherosclerotic heart disease (CHD), but there are few records in the scope of Chinese traditional medicine QIANG XIN LING (QXL) a kind of effecting traditional Chinese medicine, is established on the traditional medical chicory of Nourish Qi, activate blood circulation and Hua Yu. Proved by a great deal of clinical evidence, plays a role in reversing VR after AMI. The research is through two aspects of experimental and clinical to further explore its functional mechanism.Experimental ResearchObjective: To explore the interfering mechanism of QXL to VR after AMI which caused by legation of rats coronary artery .Methods: 85 healthy male Wistar rats were selected and randomly divided into five groups, each group had 17 rats. Rat models of AMI were established by ligation of left coronary artery, 24 hours after the operation, there were 20 rats died and the operative mortability of the curgical procedure was 23.6%. Among the survival rats, QXLmas (n=12), QXLmin (n=14) and Captopril group (n=11) were all treated with medicine by intragastric administration, while Model group (n=15) and Sham-operation group (n=13) (pericardium was opened without the ligation of the left coronary artery). Received the same does saline. Four weeks later, all rats were killed. Radvoimmunoassay was taken to determine AngⅡ(AngiotensinⅡ) and SOD(Superoxide Dismutase). LVMI(left ventricular mass index) was calculated and HE staining was employed to observe the Pathological Changes of left ventricular structure the myocardium, ABC Staining was to detect the expression of TGF-β1(Tranforming Growth Factor-β1)in the myocardium. Statistical method: The data was statistied with the soft of Spss 11.5.Results:⑴AngⅡ,SOD After four weeks treatment the contents of AngⅡof Model group and drug treatment groups were significantly higher than Sham-operation group (P<0.01), drug treatments groups` contents were lower than Model l group(P<0.05 or P<0.01). QXLmas was much lower than Captopril group and QXLmin group (P<0.01), the last two groups'difference has no statistical significance(P≥0.05).SOD: The contents of Model group and drug treatment groups were lower than Sham-operation group (P<0.01).the last there groups were higher than Model group(P<0.05) QXLmas was highest among the last there groups, the difference between QXLmas and captopril group had statistical significance (P<0.01), the content of SOD of QXLmin was also higher than Captopril group(P<0.05). LVMI: The last four groups, whose LVMI was higher than Sham- operation group (P<0.05) Captopril group, QXLmin and QXLmas were lower than Model group, the difference had statistical significance(P≥0.05). the last three groups` LVMI were lower than Model l group (P<0.05 or P<0.01). Compared with captopril group, the LVMI QXLmin was lower (P<0.05) and QXLmas was the lowest (P<0.01). TGF-β1 : Expression of TGF-β1 in Sham-operation was lower, as well TGF-β1 were detected expressed in all other groups and were higher than Sham-operation (P<0.01). TGF-β1 expressed highest in Model group (P<0.05 or P<0.01). the amount of expression in QXLmin was much lower than Captopril group, the difference had statistical significance (P<0.01).Conclusion: QXL can reverse VR after hats` AMI which caused by ligation of rats` coronary artery.Clinical ResearchObjective: To observe the interfering mechanism of QXL to the patiente's VR after AMI.Methods: 90 patients with AMI were selected and random divided into Control group (n=43) and Treatment group (n=47). All were treated with routine method of dilating coronary artery increasing the coronary artery blood circulation and treating the serious diseases happened at the same time on time. Treatment group was added the Chinese traditional medicine QXL beside the same method. After 4 weeks, observe the clinical effective, investigate the contents of AngⅡ,PⅢNP(Propeptide of type ProcollagenⅢ),TGF-β1 and SOD between before and after treatment, observe the difference of EDVI(end-diastolic volume index), ESVI(end-systolic volume index), EF(ejection fraction) and WMSI(wall motion score index) and the security. Compared with before the treatment, the contents of AngⅡ,PⅢNP,TGF-β1 significantly decreased, while the SOD increased .EDVI, ESVI and ET obviously improved at the same time. WMSI was decreased but Treatment group had more effect. (P<0.05 or P<0.01). Statistical method: The data was statistied with the soft of Spss 11.5.Results: Treatment group had more significant effect than Control group. Amory 47 patients of Treatment group, there were 21 patients had significant effect (44%), 38.5% of the patients'clinical symptom was changed better and 8% had no effect. The amount of effective of the group was 83.0% which was higher than control group.Conclusion: QXL can reverse the process of VR after AMI.