通心络对2型糖尿病合并冠心病患者不完全血运重建术预后的影响
摘要
目的观察通心络应用于2型糖尿病合并冠心病患者行不完全血运重建术后的疗效与安全性的影响。方法选取选择2015年1月—2017年1月在本院心内科治疗的123例通过经皮冠状动脉介入治疗(PCI)进行部分血运重建的冠心病合并2型糖尿病患者,随机分为通心络组(62例)和常规治疗组(61例)两组。观察两组患者服药12周后心绞痛分级(CCS分级)、主要心脏不良事件(MACE)发生情况;并于开始服药治疗前以及服药12周后,行超声心动图检查。结果两组患者在服药治疗期间的12周内MACE发生率比较,通心络组为4.8%(3/62),常规治疗组为13.1%(8/61),差异有统计学意义(P<0.05)。12周内通心络组患者心绞痛发作例数、发作次数及心绞痛CCS级别等方面均优于常规治疗组(P<0.05);左心功能的恢复结果均明显好于常规治疗组(P<0.05)。结论通心络可减少冠心病合并糖尿病患者行不完全血运重建术后心绞痛的发作,左心功能及运动耐量明显改善。
引文
[1]Picchi A,Capobianco S,Qiu T,et al.Coronary microvascular dysfunction in diabetes mellitus:a review[J].World J Cardiol,2010,2(11):377-390.
[2]Tabit CE,Chung WB,Hamburg NM,et al.Endothelial dysfunction in diabetes mellitus:molecular mechanisms and clinical implications[J].Rev Endocr Metab Disord,2010,11(1):61-74.
[3]Sena CM,Pereira AM,Sei9a R.Endothelial dysfunction-a major mediator of diabetic vascular disease[J].Biochim Biophys Acta,2013,1832(12):2216-2231.
[4]Tousoulis D,Papageorgiou N,Androulakis E,et al.Diabetes mellitus-associated vascular impairment:novel circulating biomarkers and therapeutic approaches[J].J Am Coll Cardiol,2013,62:667-676.
[5]Zhang HB,Wen JK,Zhang J,et al.Flavonoids from Inula britannica reduces oxidative stress through inhibiting expression and phosphorylation of p47(phox)in VSMCs[J].Pharm Biol,2011,49(8):815-820.
[6]Avogaro A,Albiero M,Menegazzo L,et al.Endothelial dysfunction in diabetes:the role of reparatory mechanisms[J].Diabetes Care,2011,34(S2):S285-S290.
[7]杨跃进,张健,吴永健,等.通心络、卡维地洛、缬沙坦对兔急性心肌梗死晚期再灌注微血管内皮功能及完整性保护作用的对比[J].中国病理生理杂志,2006,22(7):1366-1369.
[8]Li XD,Yang YJ,Geng YJ,et al.The cardioprotection of simvastatin in reperfused swine hearts relates to the inhibition of myocardial edema by modulating aquaporins via the pka pathway[J].Int JCardiol,2013,167(6):2657-2666.
[9]Freitas F,Estato V,Carvalho VF,et al.Cardiac microvascular rarefaction in hyperthyroidism-induced left ventricle dysfunction[J].Microcirculation,2013,20(7):590-598.
[10]Fryer LG,Foufelle F,Barnes K,et al.Characterization of the role o the AMP-activated protein kinase in the stimulation of glucose transport in skeletal muscle cells[J].Biochem J,2002,363(1):167-174.
[11]吴以岭.运用络病学说治疗心脑血管疾病[M].北京:中国科学技术出版社,2001:1-39.
[2]Tabit CE,Chung WB,Hamburg NM,et al.Endothelial dysfunction in diabetes mellitus:molecular mechanisms and clinical implications[J].Rev Endocr Metab Disord,2010,11(1):61-74.
[3]Sena CM,Pereira AM,Sei9a R.Endothelial dysfunction-a major mediator of diabetic vascular disease[J].Biochim Biophys Acta,2013,1832(12):2216-2231.
[4]Tousoulis D,Papageorgiou N,Androulakis E,et al.Diabetes mellitus-associated vascular impairment:novel circulating biomarkers and therapeutic approaches[J].J Am Coll Cardiol,2013,62:667-676.
[5]Zhang HB,Wen JK,Zhang J,et al.Flavonoids from Inula britannica reduces oxidative stress through inhibiting expression and phosphorylation of p47(phox)in VSMCs[J].Pharm Biol,2011,49(8):815-820.
[6]Avogaro A,Albiero M,Menegazzo L,et al.Endothelial dysfunction in diabetes:the role of reparatory mechanisms[J].Diabetes Care,2011,34(S2):S285-S290.
[7]杨跃进,张健,吴永健,等.通心络、卡维地洛、缬沙坦对兔急性心肌梗死晚期再灌注微血管内皮功能及完整性保护作用的对比[J].中国病理生理杂志,2006,22(7):1366-1369.
[8]Li XD,Yang YJ,Geng YJ,et al.The cardioprotection of simvastatin in reperfused swine hearts relates to the inhibition of myocardial edema by modulating aquaporins via the pka pathway[J].Int JCardiol,2013,167(6):2657-2666.
[9]Freitas F,Estato V,Carvalho VF,et al.Cardiac microvascular rarefaction in hyperthyroidism-induced left ventricle dysfunction[J].Microcirculation,2013,20(7):590-598.
[10]Fryer LG,Foufelle F,Barnes K,et al.Characterization of the role o the AMP-activated protein kinase in the stimulation of glucose transport in skeletal muscle cells[J].Biochem J,2002,363(1):167-174.
[11]吴以岭.运用络病学说治疗心脑血管疾病[M].北京:中国科学技术出版社,2001:1-39.