摘要
目的:研究不稳定型心绞痛(UA)患者在经皮冠状动脉介入(PCI)治疗前应用大剂量血脂康对炎症的抑制作用。方法:对196例临床确诊为高危UA(心绞痛Braunwald分级为Ⅲ和ⅡB级,CRP>3mg/L)的患者按随机原则分别入选A组和B组,在相似常规治疗的基础上分别口服1.2g/d和2.4g/d血脂康治疗72h。随后对所有病人进行冠状动脉造影和PCI治疗。测定在入院时、药物治疗3d后(PCI术前)和PCI术后48h的血浆CRP的水平,并随访半年内的冠脉事件和左室射血分数。结果:入院时2组血浆CRP水平无明显差别(P>0.05);治疗3d后,两组血浆CRP水平明显低于入院时[A组:(5.44±1.57)mg/Lvs(4.04±1.54)mg/L;B组:(5.42±1.36)mg/Lvs(3.60±1.14)mg/L,P<0.05];PCI术后48h,两组血浆CRP水平显著高于术前[A组升至(9.22±5.03)mg/L;B组升至(4.97±1.75)mg/L,P<0.05]。PCI术前及术后48h,B组的血浆CRP水平明显低于同期A组(P<0.05)。术后半年主要冠脉事件B组明显少于A组[21/104(20.2%)vs9/92(9.8%),P<0.05],左室射血分数B组明显高于A组(55.41%±10.93%vs59.30%±9.99%,P<0.05)。结论:PCI术前大剂量血脂康治疗对PCI术引起的炎症具有抑制作用,抑制炎症可能是PCI术后冠脉事件减少和左室射血分数增加的重要因素。
AIM： To study the inhibitory effect of high -dose Xuezhikang, administered before percutaneous coronary intervention （PCI） on inflammatory response induced by PCI in patients with unstable angina （UA）. METHODS ： All patients with UA in class Ⅲ and Ⅱ B according to Braunwald classification were considered for inclusion in the present study. Finally, 196 patients received Xuezhikang treatment 72 h before coronary angiography and successfully performed PCI with elevated C - reactive protein （CRP） level （ 〉 3 mg/L） were randomised to 2 groups ： 1.2 g/d of Xuezhikang as group A, or 2.4 g/d of Xuezhikang as group B. The levels of CRP were measured at baseline, after 3 days of therapy （ before procedure） and 48 hours after PCI. The patients were followed - up for 6 months for major adverse coronary events and left ventricular ejection fraction. RESULTS： There was no significant difference in the mean CRP level among the two randomized groups （ P 〉 0. 05 ）, however, after three days of pharmacological treatment, there was significantly reduced CRP content in group A [ （5.44 ± 1.57 ） mg/L vs （4. 04 ± 1.54） mg/L, P 〈 0. 05 ] and in group B [ （5.42 ± 1.36） mg/L vs （3.60 ± 1.14） mg/L, P 〈0.05 ] compared with admission. Measurements performed 48 hours after the procedure revealed a marked CRP level increase in group A （up to 9. 22 mg/L ±5.03 mg/L） and an obvious increase in groups B （ up to 4. 97 mg/L ± 1.75 mg/L, P 〈 0. 05 ） compared with pre - procedure. The serum level of CRP in B group was distinctly lower than that in A group before （ P 〈 0. 05 ） and after the procedure （ P 〈 0. 05 ）, respectively. Major adverse coronary events during the 6 - month clinical follow - up occurred less in group A than that in group B [21/104 （20. 2% ） vs 9/92 （9. 8% ） ; patients, P 〈0. 05]. Follow - up echocardiography revealed lower left ventricular ejection fraction in group A than that in group B （55.41% ±10.93% vs 59. 30% ±9.99%, P〈0.05）. CONCLUSION： High -dose Xuezhikang therapy, administered before PCI, has better inhibition effect than low -dose on inflammatory response induced by PCI in patients with UA. Attenuation of inflammatory response may be crucial for the reduction of coronary events following invasive coronary interventions.
出处
《中国病理生理杂志》
CAS
CSCD
北大核心
2007年第9期1703-1705,共3页
Chinese Journal of Pathophysiology
基金
山东省自然科学基金资助项目(No.Y2005C17)
关键词
血脂康
中草药
经皮冠状动脉介入
心绞痛
不稳定型
C-反应蛋白质
Xuezhikang
Drugs, Chinese herbal
Percutaneous coronary intervention
Angina, unstable
C - reactive protein
