通心络对急性冠脉综合征介入治疗术患者内皮功能和高敏C反应蛋白的影响

Effect of Tongxinluo on endothelial function and hypersensitive C-reactive protein in acute coronary syndrome patients undergoing percutaneous coronary intervention

目的:观察通心络对急性冠脉综合征经皮冠状动脉介入治疗术(percutaneous coronary inter-vention,PCI)患者内皮功能及高敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)的影响。方法:选择因冠脉狭窄病变而行PCI的冠心病不稳定型心绞痛患者33例,急性心肌梗死6例,随机分为常规治疗组(19例)和通心络组(20例);通心络组为术后常规治疗基础上加用通心络4粒(每粒0.26g),每日3次;测定术前,术后24h,术后3个月一氧化氮合酶(NOS),一氧化氮(NO)以及hs-CRP的变化,以肱动脉血流介导性扩张(flow-mediated diameter,FMD)评估血管内皮依赖性舒张功能,并对NO和hs-CRP进行相关分析。结果:PCI术后24h两组NOS,NO,FMD较术前明显减低(P<0.05),两组hs-CRP均较术前增高(P<0.05);术后3个月NOS,NO,FMD较术前明显增加(P<0.05或P<0.01),hs-CRP较术前明显减低(P<0.01或P<0.05),通心络组较常规治疗组上述变化更为显著(P<0.05),NO和hs-CRP呈负相关(r=-0.3219,P<0.01)。结论:通心络更能显著改善急性冠脉综合征PCI术患者的内皮功能,其机制可能为直接作用内皮细胞和抑制炎症反应。

Objective To determine the effect of Tongxinluo on the endothelial function and hypersensitive C-reactive protein（hs-CRP） in acute coronary syndrome patients undergoing percutaneous coronary intervention（PCI）.Methods Thirty-three patients with unstable angina pectoris and 6 patients with acute myocardial infarction who underwent PCI for stenotic lesions of the coronary artery were enrolled.The patients were randomly assigned to a conventional group（n=19） which took routine treatment or a tongxinluo group（n=20） which took Tongxinluo（4 capsules once,3 times per day） at the base of routine treatment after PCI.Nitric oxide synthase（NOS）,nitric oxide（NO）,endothelium-dependent vasodilation which was evaluated in the brachial artery flow mediated diameter（FMD） and hs-CRP were measured before the PCI and 24 hours and 3 months after the PCI.The correlation between NO and hs-CRP was analyzed.Results NOS,NO,and FMD in the 2 groups 24 hours after the PCI were significantly lower than those before the PCI（P〈0.05）,but hs-CRP obviously increased（P〈0.05）.NOS,NO,and FMD 3 months after the PCI in the 2 groups were significantly higher than those before the PCI（P〈0.05 or P〈0.01）,but hs-CRP obviously decreased（P〈0.01）.All indexes mentioned above in the Tongxinluo group showed greater changes than those of the conventional group（P〈0.05）.NO was negatively correlated with hs-CRP（r=-0.3219,P〈0.01）.Conclusion Tongxinluo capsules have obvious beneficial effect on endothelial function and anti-inflammation in acute coronary syndrome patients undergoing PCI,by directly acting on the endothelium and indirectly inhibiting inflammation.