参元益气活血胶囊对不稳定型心绞痛血瘀证病人择期PCI围术期心肌损伤的保护作用
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摘要
目的观察参元益气活血胶囊对择期经皮冠状动脉介入(PCI)围术期心肌损伤的保护作用。方法将研究对象分为非同期对照组和观察组,对照组给予常规治疗,观察组在对照组基础上加用参元益气活血胶囊治疗,观察择期PCI不稳定型心绞痛(UA)病人血清心肌标志物肌酸激酶(CK)及其同工酶(CK-MB)、超氧化物歧化酶(SOD)、丙二醛(MDA)、高敏C反应蛋白(hs-CRP)水平,同时观察参元益气活血胶囊对择期PCI围术期心绞痛的临床疗效。结果两组PCI术前CK、CK-MB、SOD、MDA比较,差异无统计学意义(P>0.05);对照组术后血清CK、CK-MB、MDA、hs-CRP水平有所升高,提示存在一定的围术期心肌损伤;观察组术后血清中CK、CK-MB、MDA水平较术前降低,SOD水平升高,与对照组比较差异有统计学意义(P<0.05)。对照组hs-CRP水平略有升高,差异有统计学意义(P<0.05)。与对照组比较,观察组hs-CRP水平降低,差异有统计学意义(P<0.05)。两组病人PCI术后心绞痛发作均明显减少,显效率相当,总有效率观察组略高,但差异无统计学意义(P>0.05)。结论参元益气活血胶囊对择期PCI围术期心肌损伤具有一定的保护作用。
Objective To observe the protective effect of Shenyuan Yiqi Huoxue capsules(SYHC)on perioperative myocardial injury in patients with unstable angina pectoris(UAP)undergoing percutaneous coronary intervention(PCI).Methods Patients with UAP and blood stasis syndrome undergoing PCI were divided into two groups:control group treated with routine treatment,and treatment group treated with routine treatment plus SYHC.The levels of serum myocardial markers creatine kinase(CK)and its isoenzyme(CK-MB),superoxide dismutase(SOD),malondialdehyde(MDA),high sensitivity C-reactive protein(hs-CRP)were observed.The clinical curative effect of angina pectoris was observed.Results There was no difference in the serum levels of preoperative CK,CK-MB,SOD,MDA between two groups(P >0.05).The serum levels of postoperative CK,CK-MB,MDA,hs-CRP were decreased in treatment group,which was lower than that in control group(P <0.05).The serum level of postoperative SOD was increased in treatment group,which was higher than that in control group(P <0.05).The serum Level of postoperative hs-CRP was increased in control group(P <0.05):compared with control group.The seum level of postoperative hs-CRP was decreased in treatment group(P <0.05).Conclusion SYHC has certain protective effect on perioperative myocardial injury in patients with UAP and blood stasis syndrome undergoing PCI.
Objective To observe the protective effect of Shenyuan Yiqi Huoxue capsules(SYHC)on perioperative myocardial injury in patients with unstable angina pectoris(UAP)undergoing percutaneous coronary intervention(PCI).Methods Patients with UAP and blood stasis syndrome undergoing PCI were divided into two groups:control group treated with routine treatment,and treatment group treated with routine treatment plus SYHC.The levels of serum myocardial markers creatine kinase(CK)and its isoenzyme(CK-MB),superoxide dismutase(SOD),malondialdehyde(MDA),high sensitivity C-reactive protein(hs-CRP)were observed.The clinical curative effect of angina pectoris was observed.Results There was no difference in the serum levels of preoperative CK,CK-MB,SOD,MDA between two groups(P >0.05).The serum levels of postoperative CK,CK-MB,MDA,hs-CRP were decreased in treatment group,which was lower than that in control group(P <0.05).The serum level of postoperative SOD was increased in treatment group,which was higher than that in control group(P <0.05).The serum Level of postoperative hs-CRP was increased in control group(P <0.05):compared with control group.The seum level of postoperative hs-CRP was decreased in treatment group(P <0.05).Conclusion SYHC has certain protective effect on perioperative myocardial injury in patients with UAP and blood stasis syndrome undergoing PCI.
引文
[1]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.非ST段抬高急性冠状动脉综合征诊断和治疗指南[J].中华心血管病杂志,2012,40(5):353-367.
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[3]中国中西医结合学会活血化瘀专业委员会.血瘀证诊断标准[J].中西医结合杂志,1987,7(3):129.
[4]Ruygrok PN,Jaegere PT,Domburg RT,et al.Clinical outcome10years after attempted percutaneous transluminal coronary angio plasty in 856patients[J].J Am Coll Cardio,1996,27(7):1669-1677.
[5]Wilson SH,Berger PB,Mathew V,et al.Immediate and late outcome after direct stent implantation without balloon predilation[J].J Am Coll Cardio,2000,35(4):937-943.
[6]Kramer JH,Misik V,Weglicki WB.Lipid peroxidation derived free radical production and postischemic myocardial reperfusion injury[J].Ann N Y Acad Sci,1994,723(10):180.
[7]Devaraj S,Valieggi S,Siegel D,et al.Role of reactive protein in contributing to increased cardiovascuar risk in metabolic syndrome[J].Curr Atheroscler Rep,2010,12(2):110-118.
[8]王琦,吴赛珠,张帆,等.男性冠心病患者血浆睾酮与超敏C反应蛋白、白介素-6及同型半胱氨酸的关系[J].中国老年学杂志,2012,32(5):889-891.
[9]朱旭,郑利平.冠心病患者血清超敏C反应蛋白、肌钙蛋白、血脂水平变化及临床意义[J].中国实验方剂学杂志,2012,18(7):258-260.
[10]陈良友,林海丽.冠心病患者C反应蛋白及同型半胱氨酸检测的临床意义[J].中国医药导报,2013,10(15):130-131.
[11]赵建香,葛建华.高敏C反应蛋白和同型半胱氨酸在冠心病诊疗中的意义[J].泰山医学院学报,2009,30(11):850-851.
[12]金志文,龚春.血清高敏C反应蛋白和颈动脉粥样硬化斑块与冠状动脉疾病的关系[J].实验与检验医学,2009,27(6):601-602.
[13]王建琼,牛华.急性冠脉综合征与超敏C反应蛋白的关系研究[J].实验与检验医学,2010,28(3):237-238.
[14]刘红旭,金玫,王振裕,等.参元丹煎剂治疗不稳定心绞痛(血瘀证)113例临床观察[J].中医杂志,1999,40(4):219-221.
[15]刘红旭,金玫,王振裕,等.参元丹与合心爽治疗不稳定性心绞痛血瘀证疗效观察[J].中国中医急症,2003,12(4):293-294.
[16]尚菊菊,李爱勇,杨洪志,等.参元丹药理预适应对大鼠缺血再灌注心肌梗死面积、蛋白激酶C及热休克蛋白70的影响[J].中华中医药杂志,2011,26(8):730-733.
[17]佟彤,刘红旭,尚菊菊,等.参元丹对缺血再灌注心肌细胞内质网应激相关因子GRP78、CHOP表达的影响[J].世界中医药,2016,11(3):407-409.
[18]刘红旭,李爱勇.参元丹后处理对缺血/再灌注大鼠血清MDA、SOD水平的影响[J].微循环学杂志,2010,20(2):66-67.
[19]褚福永,刘巍,刘红旭.益气逐瘀方对急性心肌梗死大鼠miR-24表达及心肌细胞凋亡的影响[J].世界中医药,2016,11(3):392-394.
[20]解欣然,张蕾,尚菊菊,等.参元丹含药血清对缺氧复氧心肌细胞自噬的影响[J].中华中医药杂志,2012,27(3):559-562.
[21]仇盛蕾,韩垚,戴梅,等.参元益气活血胶囊对不稳定型心绞痛患者GRACE评分的影响[J].北京中医药,2016,35(4):302-305.
[2]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:69-73.
[3]中国中西医结合学会活血化瘀专业委员会.血瘀证诊断标准[J].中西医结合杂志,1987,7(3):129.
[4]Ruygrok PN,Jaegere PT,Domburg RT,et al.Clinical outcome10years after attempted percutaneous transluminal coronary angio plasty in 856patients[J].J Am Coll Cardio,1996,27(7):1669-1677.
[5]Wilson SH,Berger PB,Mathew V,et al.Immediate and late outcome after direct stent implantation without balloon predilation[J].J Am Coll Cardio,2000,35(4):937-943.
[6]Kramer JH,Misik V,Weglicki WB.Lipid peroxidation derived free radical production and postischemic myocardial reperfusion injury[J].Ann N Y Acad Sci,1994,723(10):180.
[7]Devaraj S,Valieggi S,Siegel D,et al.Role of reactive protein in contributing to increased cardiovascuar risk in metabolic syndrome[J].Curr Atheroscler Rep,2010,12(2):110-118.
[8]王琦,吴赛珠,张帆,等.男性冠心病患者血浆睾酮与超敏C反应蛋白、白介素-6及同型半胱氨酸的关系[J].中国老年学杂志,2012,32(5):889-891.
[9]朱旭,郑利平.冠心病患者血清超敏C反应蛋白、肌钙蛋白、血脂水平变化及临床意义[J].中国实验方剂学杂志,2012,18(7):258-260.
[10]陈良友,林海丽.冠心病患者C反应蛋白及同型半胱氨酸检测的临床意义[J].中国医药导报,2013,10(15):130-131.
[11]赵建香,葛建华.高敏C反应蛋白和同型半胱氨酸在冠心病诊疗中的意义[J].泰山医学院学报,2009,30(11):850-851.
[12]金志文,龚春.血清高敏C反应蛋白和颈动脉粥样硬化斑块与冠状动脉疾病的关系[J].实验与检验医学,2009,27(6):601-602.
[13]王建琼,牛华.急性冠脉综合征与超敏C反应蛋白的关系研究[J].实验与检验医学,2010,28(3):237-238.
[14]刘红旭,金玫,王振裕,等.参元丹煎剂治疗不稳定心绞痛(血瘀证)113例临床观察[J].中医杂志,1999,40(4):219-221.
[15]刘红旭,金玫,王振裕,等.参元丹与合心爽治疗不稳定性心绞痛血瘀证疗效观察[J].中国中医急症,2003,12(4):293-294.
[16]尚菊菊,李爱勇,杨洪志,等.参元丹药理预适应对大鼠缺血再灌注心肌梗死面积、蛋白激酶C及热休克蛋白70的影响[J].中华中医药杂志,2011,26(8):730-733.
[17]佟彤,刘红旭,尚菊菊,等.参元丹对缺血再灌注心肌细胞内质网应激相关因子GRP78、CHOP表达的影响[J].世界中医药,2016,11(3):407-409.
[18]刘红旭,李爱勇.参元丹后处理对缺血/再灌注大鼠血清MDA、SOD水平的影响[J].微循环学杂志,2010,20(2):66-67.
[19]褚福永,刘巍,刘红旭.益气逐瘀方对急性心肌梗死大鼠miR-24表达及心肌细胞凋亡的影响[J].世界中医药,2016,11(3):392-394.
[20]解欣然,张蕾,尚菊菊,等.参元丹含药血清对缺氧复氧心肌细胞自噬的影响[J].中华中医药杂志,2012,27(3):559-562.
[21]仇盛蕾,韩垚,戴梅,等.参元益气活血胶囊对不稳定型心绞痛患者GRACE评分的影响[J].北京中医药,2016,35(4):302-305.