血脂康对不同血脂水平的急性冠状动脉综合征患者的干预作用

Intervention of Xuezhikang on Patients of Acute Coronary Syndrome with Different Levels of Blood Lipids

目的观察血脂康对不同血脂水平的急性冠状动脉综合征 (ACS)患者的干预作用。方法采用双盲、随机、对照方法 ,将 10 5例ACS患者分为治疗组和对照组。治疗组 5 3例 ,采用常规西药治疗并加服中药血脂康 1 2 g/d ,共 12周 ,其中正常血脂 (NBL) 2 6例 ;高血脂 (HL) 2 7例 ;对照组 5 2例 ,单用常规西药治疗 ,其中NBL 2 5例 ,HL 2 7例 ;同时设健康对照组 4 0名 ;观察治疗前后肱动脉内皮依赖性舒张功能 (FMD)变化 ,同时测定血清一氧化氮 (NO)、内皮素 1(ET 1)、C反应蛋白 (CRP)及血脂水平。结果治疗前ACS患者FMD值和血清NO水平较健康对照组明显降低 ,ET 1、CRP水平较健康对照组显著升高 ,CRP、NO及FMD与血脂LDL C存在显著的相关性。治疗 12周后 ,治疗组FMD值和血清NO水平均有明显上升 ,ET 1、CRP水平显著降低。而且与对照组比较 ,差异有显著性 (P <0 0 5 ,P <0 0 1)。血清TC、TG、LDL C水平治疗组均显著下降 ,HDL C治疗组HL患者明显上升 ,NBL患者虽有升高 ,但差异无显著性。结论早期应用中药血脂康治疗正常血脂和高血脂的ACS患者 ,均可改善内皮功能、拮抗炎症反应 ,具有稳定斑块作用。

ObjectiveTo observe the intervention of Xuezhi kang (XZK) on patients of acute coronary syndrome (ACS) with different levels of blood lipids. Methods Adopting the double blind randomized controlled method, 105 patients of ACS we re divided into two groups. The 53 patients in the treated group, 26 with normal blood lipids (NBL) and 27 with hyperlipemia (HL) were treated with conven tional western medicine plus XZK 1.2 g per day for 12 weeks. The 52 patients in the control group, 25 with NBL and 27 with HL, were treated with conventional w estern medicine alone. Besides, a healthy control group consisted of 40 subjects was set up. The changes of brachial arterial endothelium-dependent diastolic f u nction (FMD) before and after treatment was observed, the changes of blood level s of nitric oxide (NO), endothelin-1 (ET-1), C-reactive protein (CRP) and lip ids were also recorded. ResultsBefore treatment, FMD value and serum NO level wer e lower and ET-1 and CRP levels in ACS patients were higher than those in the h e althy subjects, and a significant correlation existed between CRP, NO and FMD wi th LDL-C. After treated for 12 weeks, FMD value and serum NO level increased, l e vels of ET-1 and CRP decreased significantly in the treated group, showing sign i ficant difference to those in the control group (P<0.05,P<0.01). Serum levels of TC, TG and LDL-C in the treated group lowered significantly. HDL-C level in patients with HL i n creased significantly while in those with NBL, it showed a trend of increasing b ut with no statistical significance. ConclusionApplyi ng XZK in ACS patients in early stage, either with NBL or with HL, could improve the endothelial functio n, antagonize inflammatory response to stabilize the atheromatous plaque.