活血祛痰护心方对STEMI患者PCI术后主要心血管不良事件及血清sICAM-1和sVCAM-1水平变化的影响  

Effect of Huoxue Qutan Huxin Recipe on major cardiovascular adverse events and changes of serum sICAM-1 and sVCAM-1 levels in patients with STEMI after PCI

作　　者：韩玮 熊敏俊 于雯 孔兆佳 王鑫 於四军 HAN Wei;XIONG Min-jun;YU Wen(Department of Cardiovascular Medicine,Beijing Integrated Hospital of Traditional Chinese and Western Medicine,Beijing 100039,China)

机构地区：[1]北京中西医结合医院心血管内科,北京100039 [2]解放军总医院第三医学中心心内科,北京100039

出　　处：《临床和实验医学杂志》2023年第5期465-469,共5页Journal of Clinical and Experimental Medicine

基　　金：北京市自然科学基金(编号:2020B001069)。

摘　　要：目的观察活血祛痰护心方对急性ST段抬高型心肌梗死(STEMI)患者经皮冠状动脉介入(PCI)术后主要心血管不良事件及血清可溶性细胞间黏附分子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)水平变化的影响。方法前瞻性选取2020年1月至2022年4月在北京中西医结合医院、解放军总医院第三医学中心行直接PCI治疗的106例STEMI患者为研究对象,采用简单随机法将其分为两组,每组53例。对照组术后采用常规药物治疗,观察组术后在常规药物基础上联合活血祛痰护心方治疗。检测两组血清sICAM-1、sVCAM-1、心功能、6 min步行距离(6WMD)及N末端脑钠肽前体(NT-ProBNP)的差异,比较两组心电图ST段回落情况和主要心血管不良事件(MACE)发生率。结果治疗后,观察组和对照组LVEF、E/A及6WMD高于治疗前,血清sICAM-1、sVCAM-1、NT-ProBNP及LVEDD低于治疗前,且观察组治疗后LVEF、E/A及6WMD为(50.89±4.33)%、1.48±0.32、(382.03±58.14)m,均高于对照组[(47.96±5.13)%、1.36±0.29、(359.74±53.22)m],血清sICAM-1、sVCAM-1、NT-ProBNP及LVEDD为(243.66±24.77)ng/mL、(384.14±38.51)ng/mL、(741.25±241.23)pg/mL、(42.15±3.94)mm,均低于对照组[(264.12±29.14)ng/mL、(402.12±46.12)ng/mL、(896.36±278.56)pg/mL、(45.89±4.13)mm],差异均有统计学意义(P<0.05)。观察组心电图ST段回落指数为(71.85±13.02)%,高于对照组[(60.45±10.19)%],但心电图ST段回落率与对照组(73.58%vs.60.38%)比较,差异无统计学意义(P>0.05)。观察组MACE发生率为11.32%,低于对照组(26.42%),差异有统计学意义(P<0.05)。结论活血祛痰护心方可改善STEMI患者术后心功能,降低血清sICAM-1、sVCAM-1的表达,降低心血管不良事件的发生。Objective To observe the effects of Huoxue Qutan Huxin Recipe on the major adverse cardiovascular events and the changes of serum soluble intercellular adhesion molecule-1(sICAM-1)and soluble vascular cell adhesion molecule-1(sVCAM-1)levels in patients with acute ST segment elevation myocardial infarction(STEMI)after percutaneous coronary intervention(PCI).Methods Prospectively select 106 patients with STEMI who were treated by primary PCI in Beijing Integrated Hospital of Traditional Chinese and Western Medicine and The Third Medical Center of the PLA General Hospital from January 2020 to April 2022 as the research object,and divide them into two groups by simple random method,53 cases in each group.The control group was treated with routine drugs after operation,and the observation group was treated with the combination of blood activating,phlegm removing and heart protecting formula on the basis of routine drugs after operation.The differences of serum sICAM-1,sVCAM-1,cardiac function,6-minute walking distance(6WMD)and N-terminal pro brain natriuretic peptide(NT ProBNP)between the two groups were detected,and the ST segment depression of ECG and the incidence of major adverse cardiovascular events(MACE)were compared between the two groups.Results The levels of LVEF,E/A,and 6WMD in the observation group and control group after treatment were higher than those before treatment,the levels of serum sICAM-1,sVCAM-1,NT ProBNP and LVEDD were lower than those before treatment,and the levels of LVEF,E/A and 6WMD in the observation group after treatment were(50.89±4.33)%,1.48±0.32,(382.03±58.14)m,which were higher than those in the control group[(47.96±5.13)%,1.36±0.29,(359.74±53.22)m],and the levels of serum sICAM-1,sVCAM-1,NT-ProBNP and LVEDD were(243.66±24.77)ng/mL,(384.14±38.51)ng/mL,(741.25±241.23)pg/mL,(42.15±3.94)mm,which were significantly lower than those in the control group[(264.12±29.14)ng/mL,(402.12±46.12)ng/mL,(896.36±278.56)pg/mL,(45.89±4.13)mm],the differences were statistically significant

关 键 词：急性ST段抬高型心肌梗死 活血祛痰护心方 经皮冠状动脉介入 ST段回落指数 心血管不良事件 

分 类 号：R259[医药卫生—中西医结合]