CAJ | 학술논문

目的观察急性冠脉综合征(ACS)患者冠脉支架植入术前后血管内皮功能的变化,在冠脉支架植入术后给予常规药物治疗,或疏血通注射剂干预,了解疏血通对该变化的影响.方法采用随机对照方法将60例急性冠脉综合征患者分为两组,每组30例;常规治疗组在冠脉支架植入术后给予常规药物治疗(按冠心病二级预防及ACS治疗指南用药);疏血通组在冠脉支架植入术后给予常规药物治疗的基础上,加用疏血通注射剂(单味中药水蛭提取物,主要成分为水蛭素)10毫升,天,疗程10天.冠脉支架植入术前后及疏血通治疗前后分别应用FDM法测定血浆内皮因子:血浆内皮素(ETI)、血栓烷B2(TXB2)、6-酮-前列腺素(6-keto-PGF1a)测定,双重评价其血管内皮功能;同时观察两组患者的近期预后.结果两组间冠脉支架植入术前比较,两组FDM、6-酮-前列腺素(6-keto-PGF1a)水平均差异无显著性,术后血浆内皮素(ET1)、血栓烷B2(TXB2)均较术前明显提高,6-酮-前列腺素(6-keto-PGF1a)水平明显下降(P<0.05);经10天治疗后,两组FDM均明显提高,血浆内皮素(ETI)、血栓烷B 2(TXB2)有所下降,6-酮-前列腺素(6-keto-PGF1a)有显著性升高(P<0.05),且疏血通治疗组与常规治疗组间比较差异有非常显著性(P<0.01);住院期间心血管事件发生率差异无显著性,但疏血通组较低.结论接受支架植入术患者的血管内皮功能在术后有明显-过性受损,疏血通可显著改善支架植入术治疗后急性冠脉综合征(ACS)患者的血管内皮功能,且有改善近期预后的倾向.
목적 관찰급성관맥종합정(ACS)환자관맥지가식입술전후혈관내피공능적변화,재관맥지가식입술후급여상규약물치료,혹소혈통주사제간예,료해소혈통대해변화적영향.방법채용수궤대조방법장60례급성관맥종합정환자분위량조,매조30례;상규치료조재관맥지가식입술후급여상규약물치료(안관심병이급예방급ACS치료지남용약);소혈통조재관맥지가식입술후급여상규약물치료적기출상,가용소혈통주사제(단미중약수질제취물,주요성분위수질소)10호승,천,료정10천.관맥지가식입술전후급소혈통치료전후분별응용FDM법측정혈장내피인자:혈장내피소(ETI)、혈전완B2(TXB2)、6-동-전렬선소(6-keto-PGF1a)측정,쌍중평개기혈관내피공능;동시관찰량조환자적근기예후.결과량조간관맥지가식입술전비교,량조FDM、6-동-전렬선소(6-keto-PGF1a)수평균차이무현저성,술후혈장내피소(ET1)、혈전완B2(TXB2)균교술전명현제고,6-동-전렬선소(6-keto-PGF1a)수평명현하강(P<0.05);경10천치료후,량조FDM균명현제고,혈장내피소(ETI)、혈전완B 2(TXB2)유소하강,6-동-전렬선소(6-keto-PGF1a)유현저성승고(P<0.05),차소혈통치료조여상규치료조간비교차이유비상현저성(P<0.01);주원기간심혈관사건발생솔차이무현저성,단소혈통조교저.결론접수지가식입술환자적혈관내피공능재술후유명현-과성수손,소혈통가현저개선지가식입술치료후급성관맥종합정(ACS)환자적혈관내피공능,차유개선근기예후적경향.
Objective To investigate the influence of Chinese patent medicine Shuxuetong on the prognosis and endothelial function and cardiovascular event in acute coronary syndrome(ACS) patients.Methods 60 ACS patients with significant coronary artery stenosis lesion of coronary artery were randomly divided into two groups, the control group and the experiment group. The control group were given standard drug therapy (follow the guidelines of ACS) after the PCI implantation;The experiment group were given Shuxuetong, based on the treatment of the control group. Before treatment, and i0 days after the treatment, the changes in flow-mediated dilation(FMD) inbrachial artery detected through high-resolution uhrasonography, the levels of serum endothelins: ETI、TXB2、6-keto-PGF were teated,and at the same time, the incidences of unstable anginapectoris and acute myocardial infarction, and mortality during the periods of hospitalization were compared between the two groups.Results It was significantly higher in FMD (P<0.05)and significantly lower in ET1 (P<0.05),TXB2(P<0.05) level in the experimental group than that in the control group after 10 days' treatment. There was also a significant difference in 6-keto-PGF between the two groups(P<0.05); and a significant difference was found between the beginning and 10 days after treatment in both groups (P<0.05). Within the periods of hospitalization the incidences of unstable anginapectoris and acute myocardial infarction, and mortality seems to be higher in the experi-mental group than that in the control(P=0.04) .Conclusiona PCI implantation may has the temporary damage to endothelial function of the patients with acute coronary syndrome(ACS);Shuxuetong can signifi-cantly raise FMD and reduce the level of ET1、TXB2 in acute coronary syndrome(ACS) patients, and also seems to improve the prognosis of them.