血栓通注射液对急性冠脉综合征患者介入治疗术后血脂、炎症因子及内皮功能的影响

Influence of Blood Lipids, Inflammatory Factors and Endothelial Function in Patients with Acute Coronary Syndrome After PCI by Xueshuantong Injection

摘要:

目的: 探究血栓通注射液对急性冠脉综合征患者介入治疗术后血脂、炎症因子及内皮功能的影响. 方法: 将2012年12月至2014年6月期间80例经皮冠状动脉介入治疗(PCI)治疗的急性冠状动脉综合征患者纳入本次研究,并按随机数字均衡分为治疗组和对照组,各40例,对照组采用常规药物治疗,在对照组治疗的基础上,治疗组采用血栓通注射液进行治疗.对比两组手术前后血脂水平变化、炎症因子、内皮功能及不良反应等情况. 结果: ①研究组血流分级(TIMI)中0级 0例,Ⅰ级0例,Ⅱ级6例,Ⅲ级34例,对照组分别为0,0,5,25例,两组差异显著,具有统计学意义(P <0.05);②经过药物干预术后1个月,两组的甘油三酯(TG),总胆固醇(TC),低密度脂蛋白-胆固醇(LDL-C)水平均较术前下降,高密度脂蛋白胆固醇(HDL-C)水平较术前上升,差异存在统计学意义(P< 0.05).治疗组术后的TC,TG,LDL-C水平较对照组低,HDL-C水平较对照组高,组间比较差异存在统计学意义(P< 0.05).③两组术前的超敏C-反应蛋白(hs-CRP),白介素-6(IL-6),内皮素(ET),纤维蛋白原(Fg),血管性血友病因子(vWF)均无显著性差异,两组术后1 d hs-CRP,IL-6,ET,Fg,vWF均较术前有所上升,但组间差异不显著,两组术后1月hs-CRP,IL-6,ET,Fg,vWF较术前和术后1 d均下降,差异显著(P< 0.05),且治疗组术后1月hs-CRP,IL-6,ET,Fg,vWF较对照组低,组间差异具有统计学意义(P< 0.05).④在术后1个月内,对照组出现心绞痛4例,心肌梗死1例,心脏事件发生率为12.5%,治疗组出现心绞痛2例,心肌梗死0例,心脏事件发生率为5.0%,两组心脏事件发生率差异无统计学意义. 结论: 血栓通注射液能控制急性冠脉综合征患者介入治疗术后血脂,抑制炎症反应,改善内皮功能,降低术后心脏事件发生.

Abstract:

Objective: The aim of this study was to explore the influence of blood lipids, inflammatory factors and endothelial function in patients with acute coronary syndrome after percutaneous coronary intervention(PCI) by Xueshuantong injection. Method: In this study, eighty acute coronary syndrome patients treated by PCI between December 2012 and June 2014 were included, and according to the random numbers, they were divided into treatment group and control group, with 40 cases in each group. The control group was given conventional drug treatment, on the basis of the control group, the treatment group was given Xueshuantong injection for treatment. The lipid level, inflammation factors, endothelial function and adverse reactions before and after surgery were compared. Result: In treatment group, there was no case with thrombolysis in myocardial infarction(TIMI) grade of level 0, 0 case in level Ⅰ, 6 cases in level Ⅱ, 34 cases in level Ⅲ.In control group, there was 0 case in level 0, 0 cases in level Ⅰ, 15 cases in level Ⅱ, 25 cases in level Ⅲ, with significant difference compared to treatment group(P <0.05).After drug intervention for one month after sugery, the levels of total cholesterol(TC), triglyceride(TG), low density lipoprotein-cholesterol (LDL-C) in both two groups were decreased, while the level of high density lipoprotein-cholesterol (HDL-C) was increased, with significance difference (P <0.05). The levels of TC,TG, LDL-C in treatment group was lower than those in control group, the level of HDL-C was higher than that in control group, with significant difference (P <0.05). Preoperative high-sensitivity C-reactive protein(hs-CRP),interleukin-6(IL-6), endothelin(ET),fibrinogen(Fg), von willebrand factor(vWF) one day after surgery were all increased, but with no significant difference between two groups. The hs-CRP, IL-6, ET, Fg, vWF one month after surgery in two groups were decreased with significant difference (P <0.05), and the hs-CRP, IL-6, ET, Fg, vWF one month after surgery in treatment group were lower than those of control group with statistical significance (P <0.05). Within a month after surgery, in control group there were 4 cases for angina pectoris, 1 case for myocardial infarction, the incidence of cardiac event was 12.5%;while in treatment group there were 2 cases for angina pectoris, none for myocardial infarction, the incidence of cardiac event was 5.0%, with no statistically significant differences between two groups. Conclusion: Xueshuantong injection can control postoperative blood lipids in patients with acute coronary syndromes, inhibit inflammation, improve endothelial function,and reduce postoperative cardiac events.