通心络对急性冠脉综合征患者预后及内皮功能的影响  

Influence of Tongxinluo on the Prognosis and Endothelial Function in Acute Coronary Syndrome Patients

作　　者：李树仁[1] 齐晓勇[1] 张建清[1] 吴迪[1] 胡福丽[1] 王进华[2] 王小平[2] 赵晓云[3] 党懿[1] 王天红[1] 董洁[1] 荀丽颖[1] 杨国然[4] 

机构地区：[1]河北省人民医院心脏中心,河北省石家庄市050051 [2]河北省人民医院心功能科,河北省石家庄市050051 [3]河北省人民医院临床研究中心,河北省石家庄市050051 [4]河北省人民医院病案室,河北省石家庄市050051

出　　处：《中国全科医学》2006年第17期1419-1421,共3页Chinese General Practice

摘　　要：目的研究中成药通心络对急性冠脉综合征(ACS)患者血管内皮功能及心血管事件的影响。方法将120例经冠脉造影证实为冠脉狭窄超过50%的ACS患者随机分为对照组和试验组各60例。对照组给予降压、降糖、调脂、抗血小板、抗凝、改善心肌供血等治疗,试验组在此基础上加用中成药通心络。治疗前及治疗后6、12个月,分别利用高分辨率超声测定肱动脉血流介导的内皮依赖性舒张功能(FMD)、血清一氧化氮(NO)、内皮素(ET)及其比值、总一氧化氮合酶(TNOS)以及血脂的变化,同时观察两组患者因不稳定型心绞痛住院、急性心肌梗死、血管重建、死亡等事件发生情况。结果(1)试验组和对照组患者12个月内因不稳定型心绞痛的住院率间差别有显著性意义(P<0.05)。(2)6个月及12个月时试验组患者的FMD、NO水平与对照组间差别均有显著性意义(P<0.05),ET水平间差别无显著性意义(P>0.05)。6个月时试验组患者NO/ET水平与对照组间差别有显著性意义(P<0.05);12个月时试验组患者TNOS水平与对照组间差别有显著性意义(P<0.05)。(3)6个月时患者的FMD与NO呈正相关(P<0.01),12个月时NO与TNOS呈正相关(P<0.01)。结论通心络可显著减少ACS患者因不稳定型心绞痛的住院率;在常规治疗冠心病的基础上,加服通心络可进一步改善肱动脉血流介导的内皮舒张功能,提高血一氧化氮的浓度、降低内皮素浓度,提高NO/ET比值;通心络改善内皮功能与用药后TNOS增高,促进NO合成有关。Objective To investigate the influence of Chinese patent herbal medicine Tongxinluo on the prognosis and endothelial function and cardiovascular event in acute coronary syndrome （ACS） patients. Methods 120 ACS patients with at lest one coronary artery stenosis over 50% were randomly divided into two groups, the control group and the experiment group. The control group the patients were given hypotensor, hypoglycemic, lipid- lowering, anti -platelet, anti -coagulant, and myocardial blood supply improving remedies. The experiment group the patients were given Tongxinluo, based on the drugs in the control group. Before treatment, and six and twelve months after treatment, the changes in flow - mediated dilation （FMD） in brachial artery detected through high - resolution uhrasonography, the levels of serum nitrogen monoxide （NO） , endothelins （ ET）, nitric oxide synthase （NOS） , and blood lipid were investigated; and at the same time, the incidences of unstable angina pectoris and acute myocardial infarction, and the events of vascular rebuilding and death were compared between the two groups. Results Within the twelve months the hospitalization rate because of unstable angina pectoris was lower in the experimental group than that in the control group （ P 〈0. 05）. Compared with the control group, at the sixth and twelfth month, a significant difference was found in FMD and NO （ P 〈 0. 05） , but ET levels has no significant difference （ P 〉 0. 05） ; at the sixth month, a significant difference was found in NO/ET （ P 〈 0. 05） ; at the twelfth month, a significant difference was found in NOS （ P 〈 0. 05）. At the sixth month, FMD was of a positive correlation to NO （ P 〈 0. 01 ） , and at the twelfth month NO was of a positive correlation to TNOS （ P 〈 0.01 ）. Conclusion Tongxinluo can significantly reduce the hospitalization rate due to unstable angina pectoris. Tongxinluo can raise FMD and NO levels, reduce ET level and increase the ratio of NO/ET in ACS pati

关 键 词：急性冠脉综合征 内皮 血管 血管舒张 通心络 

分 类 号：R543[医药卫生—心血管疾病]