安心通络方联合替罗非班对急性心肌梗死PCI后患者血浆sICAM-1及心功能指标的影响
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摘要
目的观察安心通络方联合替罗非班对急性心肌梗死经皮冠状动脉介入术(PCI)后患者血浆可溶性细胞黏附因子-1(sICAM-1)及心功能指标的影响。方法将120例急性心肌梗死PCI后患者随机分为2组,对照组60例给予替罗非班治疗,观察组60例在此基础上加用安心通络方治疗,观察2组治疗前及治疗4周后主要证候评分及血浆sICAM-1、心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、脑钠肽(BNP)水平变化情况,统计2组临床疗效和主要心血管不良事件(MACE)发生情况。结果治疗后2组胸痛胸闷、心悸气短、疲倦乏力、面色紫暗、舌淡紫及脉细涩评分和血浆sICAM-1、CK-MB、cTnI、BNP水平均显著降低(P均<0.05),且观察组以上指标均显著低于对照组(P均<0.05);观察组治疗总有效率显著高于对照组(P<0.05),随访MACE发生率显著低于对照组(P<0.05)。结论安心通络方联合替罗非班用于急性心肌梗死PCI后患者可有效缓解相关症状体征,调节sICAM-1、CK-MB、cTnI及BNP水平,并有助于避免远期MACE发生风险。
Objective It is to observe the effects of Anxin Tongluo decoction combined with tirofiban on plasma soluble cell adhesion factor-1( sICAM-1) and cardiac function in patients with acute myocardial infarction after percutaneous coronary intervention( PCI). Methods 120 patients with acute myocardial infarction after PCI were randomly divided into 2 groups,60 patients in the control group were treated with tirofiban,60 patients in the observation group were treated with Anxintongluo decoction based on the control group. The changes of main syndrome scores and the levels of plasma sICAM-1,cardiac troponin I( cTnI),creatine kinase isoenzyme( CK-MB) and brain natriuretic peptide( BNP) before treatment and after 4 weeks of treatment were observed in both groups,the clinical efficacy and major cardiovascular adverse events( MACE) were evaluated or recorded in both groups. Results After treatment,the scores of chest pain,chest palpitations,palpitations,fatigue,fatigue,dull purple,pale purple and fine sputum and the levels of plasma sICAM-1,CK-MB,cTnI and BNP were significantly decreased in both groups( P < 0. 05),the above indexes of the observation group were significantly lower than those in the control group( P < 0. 05). The total effective rate of the observation group was significantly higher than that of the control group( P < 0. 05),and the incidence of MACE was significantly lower than that of the control group( P < 0. 05). Conclusion Anxin Tongluo combined with tirofiban can effectively alleviate related symptoms and signs,regulate sICAM-1,CK-MB,cTnI and BNP levels,and help to avoid long-term MACE risk in the patients with acute myocardial infarction after PCI.
Objective It is to observe the effects of Anxin Tongluo decoction combined with tirofiban on plasma soluble cell adhesion factor-1( sICAM-1) and cardiac function in patients with acute myocardial infarction after percutaneous coronary intervention( PCI). Methods 120 patients with acute myocardial infarction after PCI were randomly divided into 2 groups,60 patients in the control group were treated with tirofiban,60 patients in the observation group were treated with Anxintongluo decoction based on the control group. The changes of main syndrome scores and the levels of plasma sICAM-1,cardiac troponin I( cTnI),creatine kinase isoenzyme( CK-MB) and brain natriuretic peptide( BNP) before treatment and after 4 weeks of treatment were observed in both groups,the clinical efficacy and major cardiovascular adverse events( MACE) were evaluated or recorded in both groups. Results After treatment,the scores of chest pain,chest palpitations,palpitations,fatigue,fatigue,dull purple,pale purple and fine sputum and the levels of plasma sICAM-1,CK-MB,cTnI and BNP were significantly decreased in both groups( P < 0. 05),the above indexes of the observation group were significantly lower than those in the control group( P < 0. 05). The total effective rate of the observation group was significantly higher than that of the control group( P < 0. 05),and the incidence of MACE was significantly lower than that of the control group( P < 0. 05). Conclusion Anxin Tongluo combined with tirofiban can effectively alleviate related symptoms and signs,regulate sICAM-1,CK-MB,cTnI and BNP levels,and help to avoid long-term MACE risk in the patients with acute myocardial infarction after PCI.
引文
[1]苏懿,王磊,张敏州.急性心肌梗死的流行病学研究进展[J].中西医结合心脑血管病杂志,2012,10(4):467-469
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[11]王华,卢青,刘越美,等.超微通阳调心方对扩展型心肌病大鼠心肌细胞凋亡及BNP的影响[J].湖南中医药大学学报,2010,30(9):64-77
[12]Zhao B,Li J,Luo X,et al.The role of von Willebr and factor and ADAMTS13 in the no-reflow phenomenon:after primary percutaneous coronary intervention[J].Tex Heart Inst J,2011,38(5):516-522
[13]Winchester DE,Wen X,Brearley WD,et al.Efficacy and safety of glycoprotein IIb/IIIa inhiitors during elective coronary revascularization:a metanalysis of randomized trials performed in the era of stents and thienopyridines[J].J Am Coll Cardiol,2011,57(10):1190-1199
[14]卢健棋,何贵新,潘朝锌,等.安心颗粒联合替罗非班对急性心肌梗死PCI术后患者临床疗效的研究[J].中国中药杂志,2014,39(5):920-924
[15]龙卫平,陈剑,何汉康,等.益心饮对急性心肌梗死PCI术后患者中医证候及左心功能的影响[J].湖南中医药大学学报,2013,33(5):78-80
[16]仝欣.黄芪主要活性成分的药理作用[J].时珍国医国药,2011,22(5):1246-1249
[17]孙建宁.中药药理学[M].北京:中国中医药出版社,2014:96-157
[18]刘文雅,王曙东.地龙药理作用研究进展[J].中国中西医结合杂志,2013,33(2):282-285
[2]中华医学会心血管病学分会介入心脏病学组,中华心血管病杂志编辑委员会.中国经皮冠状动脉介入治疗指南2012[J].中国医学前沿杂志,2012,4(12):50-59
[3]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心血管病预防指南[J].中华心血管病杂志,2011,36(1):3-22
[4]刘军明,邓家强.益气活血法对心肌梗死患者PCI术后心肌及血管内皮保护作用的研究[J].河南中医,2015,35(7):1522-1524
[5]中华医学会心血管病学分会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2010,38(8):675-690
[6]国家中医药管理局.中医病证诊断疗效标准[S].南京:南京大学出版社,1994:144
[7]国家中医药管理局.中药新药临床研究指导原则(试行)[S].北京:中国医药科技出版社,2002:113
[8]张亚平,张敏,马秀萍,等.超负荷量氯吡格雷对急性心肌梗死急诊PCI后心肌微循环再灌注的影响[J].微循环学杂志,2014,24(1):35-36
[9]张力俨,张翠丽,富路.急性心肌梗死经皮冠状动脉介入治疗研究进展[J].心血管病学杂志,2011,32(1):64-66
[10]陈仲敏,黄达梅,吴立荣.血清s ICAM-1、IL-6、CRP水平与急性心肌梗死的关系[J].贵阳医学院学报,2002,27(4):297-302
[11]王华,卢青,刘越美,等.超微通阳调心方对扩展型心肌病大鼠心肌细胞凋亡及BNP的影响[J].湖南中医药大学学报,2010,30(9):64-77
[12]Zhao B,Li J,Luo X,et al.The role of von Willebr and factor and ADAMTS13 in the no-reflow phenomenon:after primary percutaneous coronary intervention[J].Tex Heart Inst J,2011,38(5):516-522
[13]Winchester DE,Wen X,Brearley WD,et al.Efficacy and safety of glycoprotein IIb/IIIa inhiitors during elective coronary revascularization:a metanalysis of randomized trials performed in the era of stents and thienopyridines[J].J Am Coll Cardiol,2011,57(10):1190-1199
[14]卢健棋,何贵新,潘朝锌,等.安心颗粒联合替罗非班对急性心肌梗死PCI术后患者临床疗效的研究[J].中国中药杂志,2014,39(5):920-924
[15]龙卫平,陈剑,何汉康,等.益心饮对急性心肌梗死PCI术后患者中医证候及左心功能的影响[J].湖南中医药大学学报,2013,33(5):78-80
[16]仝欣.黄芪主要活性成分的药理作用[J].时珍国医国药,2011,22(5):1246-1249
[17]孙建宁.中药药理学[M].北京:中国中医药出版社,2014:96-157
[18]刘文雅,王曙东.地龙药理作用研究进展[J].中国中西医结合杂志,2013,33(2):282-285