舒心饮对冠状动脉支架术后应用的初步观察  

Preliminary Observation on Application of Shuxinyin after Coronary Artery Stenting

作　　者：王显[1] 林钟香[1] 葛均波[2] 李陪成[1] 刘旭[3] 何燕[1] 张振贤[1] 沈琳[1] 

机构地区：[1]上海中医药大学附属龙华医院 [2]复旦大学附属中山医院 [3]上海市胸科医院

出　　处：《中国中西医结合杂志》2002年第11期809-812,共4页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：上海市教委高校基金课题 (No .99c66)

摘　　要：目的 :观察舒心饮与抗血小板药物联合应用对冠状动脉支架血栓等术后冠脉事件的预防作用。方法 :选择支架植入成功的冠心病患者 4 4例 ,随机分为治疗组 (2 0例 )和对照组 (2 4例 ) ,两组均服用支架植入术常规用抗血小板药 ,治疗组加用舒心饮 ,采用双缩尿法、激光散射比浊法和流式细胞术检测两组患者行支架植入术前、术后即刻和术后 30天时的血浆纤维蛋白原 (Fg)、C 反应蛋白 (CRP)和血小板膜糖蛋白(GP)Ⅱb/Ⅲa、P选择素 (CD6 2 P)的变化 ,并计算两组气阴两虚、气虚和血瘀证积分值。结果 :与对照组比较 ,治疗组血浆CRP显著下降 (P <0 0 5 ) ,GPⅡb/Ⅲa和CD6 2 P也有降低的趋势 ;支架术后气阴两虚、气虚和血瘀证积分值显著降低 (P <0 0 5或P <0 0 1) ;经 6个月临床随访 ,治疗组心绞痛复发率显著低于对照组 (P<0 0 5 ) ,其他复发冠脉事件也较少。结论 :舒心饮与抗血小板药联合应用能预防冠脉支架血栓等术后冠脉事件 。Objective: To evaluate the preventive effect of antiplatelet regimens and it′s combination with Shuxinyin (SXY) on coronary events including stent thrombosis after stenting implantation. Methods: Forty four patients with successful implantation stenting in a native coronary artery were randomly assigned to treated group (n=20) and control group (n=24).The treated group received SXY and antiplatelet therapy. The patients in the control group were treated with antiplatelet regimens alone. Platelet activation was assessed before and immediately after the stenting by flow cytometry measurement of expression of CD 62 P (P selectin) and glycoprotein (GP)Ⅱb/Ⅲa receptor. It was reassessed on the thirtieth day after stenting. Plasma fibrinogen (Fg) and C reaction protein (CRP) were measured by biuret and laser scattering turbidimetry respectively at the same time. Observation was made on the scoring of the symptoms of Qi asthenia syndrome, Qi Yin asthenia syndrome and blood stasis syndrome in the two groups. Results: Compared with the control group, plasma CRP was remarkably reduced (P<0 05) in the treated group, it also showed the tendency to decrease plasma (GP) Ⅱb/Ⅲa, CD 62 P. The scoring of Qi Yin asthenia syndrome, Qi asthenia syndrome and blood stasis syndrome could be evidently decreased after stenting (P<0 05 or 0.01). Survey of six month follow up found 40% relapse of angina pectoris with 4 cases of in stent restenosis proved by angiograph in the treated group. But the relapse of angina pectoris in the control group was 67% with 2 cases of myocardial infarction, 7 cases of in stent restenosis proved by angiograph and one case died. Conclusion: Combination with SXY and antiplatelet regimens can prevent coronary events including stent thrombosis after stenting implantation and seems superior to antiplatelet treatment alone.

关 键 词：舒心饮 冠状动脉支架术 术后 冠脉事件 预防 血浆纤维蛋白原 血小板膜糖蛋白 C-反应蛋白 

分 类 号：R541.4[医药卫生—心血管疾病]