Shengmai Injection In Preventing Acute Myocardial Infarction After Interventional Reperfusion Injury In Clinical Research

Acute Myocardial Infarction (AMI) is most commonly triggered by the disruption of an atherosclerotic plaque in a coronary artery, which leads to a clotting cascade, sometimes resulting in total occlusion of the artery. The key to treatment is quick restoration of blood flow with thrombolytic therapy or percutaneous coronary intervention (PCI) to open the artery as soon as possible for cardiac reperfusion. Many clinical studies indicate that early emergency treatment of AMI with PCI (including deploying an intracoronary stent) can help salvage the myocardium, reduce myocardial infarction, sustain the contraction of left ventricle, prevent left ventricle from enlarging and remodeling, reduce mortality and morbidity of complications, and improve the long-term and near-term prognosis. However, about 10%-30% AMI patients receiving PCI treatment may develop complications such as no– reflow or slow- reflow,resulting in less effective reperfusion of myocardium, recurrent myocardial infarction, severe arrhythmia and heart failure. Reperfusion is like a double-edged sword. On one hand, it can reduce myocardial infarction by improving oxygen supply to the heart muscle and reducing cardiac ischemia; on the other hand, it may also cause myocardial injury. The ideal treatment of AMI, therefore, is to realize full reperfusion of myocardium after revascularization of coronary artery. This research objective To study the protective effects and control of shengmaion myocardium after reperfusion in patients with acute myocardium infarction. (AM I) during directpercutaneous coronary interventions( PC I) .Methods: In the clinical study, 60 AMI patients with PCI treatment are randomly divided into two groups in the control experiment. 30 patients in the control group received regular medical treatment with aspirin, Plavix, Lipitor, Low-molecular-weight Sodium,ACE-Inhibitor,Beta-Adrenoceptor ect. The other 30 patients in the treatment group received Shengmai Zhusheye in addition to the regular n medical treatment. 10ml iv and 50ml ivgtt Qd of Shengmai Zhusheye (a 999 Company product) are given respectively before and after PCI operation for a period of 7 days. Observations of MIRI occurrences, which includes ReflowArrhythmias,no - reflow﹠slow- reflow,Congestive Heart Failure and Hard Cardiology Incidents, have been made to evaluate the prevention of MIRI using Shengmai Zhusheye.Results: The clinical study indicates: 1. There are no significant differences between patients of the two groups in age, gender and AMI severity prior to PCI treatment (P>0.05); 2. There are no significant differences in MIRI occurrence between the two groups as indicated in the X2 test. The fact that X2=3.563,P=0.468,P>0.05 indicates occurrence of similar types of arrhythmia in both groups; 3. The X2 test further indicates that there is significant difference in the severity of arrhythmia between the two groups (X2=4.444 P=0.035,P<0.05), which means the treatment group has better results in the prevention of MIRI after PCI. The comparative study of myocardial ischemia - reperfusion injury (as indicated indirectly by the cardiac muscle enzyme level after PCI operation) also shows significant differences between the groups with the treatment group having much better effects in lowering the cardiac muscle enzyme level. The comparative study of myocardial depression shows significant differences between the groups with the treatment group having much better effects in refrain myocardial depression。Conclusion: A patient's gender, age or severity of AMI before PCI treatment has little impact on the prevention of MIRI; Regular western medical treatment and the joint treatment with both Chinese and Western medicine have caused similar types of arrhymia; This pathogenesis is deficiency as primary and excess as secondary . Shengmai Zhusheye has the effect of supplementing qi and nourishing yin , recuperating depleted yang and rescuing the patient form collapse , and can effectively prevent MIRI after PCI treatment of AMI.