大剂量血脂康在经皮冠状动脉介入术中的炎症抑制作用  

Inhibitory effect of high-dose Xuezhikang on inflammatory response induced by percutaneous coronary intervention in patients with unstable angina

作　　者：刘尊齐[1] 崔连群[1] 王勇[1] 孔庆赞[1] 刘继东[1] 李峰[1] 盖玉生[1] 赵传艳[1] 

机构地区：[1]山东大学山东省立医院心内科,山东济南250012

出　　处：《中国病理生理杂志》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)

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.

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 

分 类 号：R363[医药卫生—病理学]