苦碟子对经皮冠状动脉介入治疗术后基质金属蛋白酶水平和支架内血栓形成的影响

Effect of Kudiezi injection on stent thrombosis and matrix metalloproteinase in patients with PCI

目的:探讨苦碟子注射液对经皮冠状动脉介入治疗(PCI)术后支架内血栓形成、基质金属蛋白酶(MMPs)和血栓素B2(TXB2)水平的影响,阐明苦碟子注射液减少PCI术后支架内血栓发生的机制。方法:40例老年冠心病患者行PCI术后随机分为2组,实验组(n=20)给予苦碟子注射液,对照组(n=20)常规内科治疗,所有患者在术前、术后6个月测定MMPs及TXB2,术后检查冠状动脉造影及观察主要心血管事件发生情况(再狭窄、心源性死亡、心肌梗死、再次血运重建术)。结果:与术前比较,实验组、对照组PCI术后MMPs、TXB2水平均下降(P<0.05),术后实验组低于对照组(P<0.05)。术后实验组心血管事件发生率低于对照组(P<0.05)。结论:苦碟子注射液可以降低PCI术后MMPs、TXB2水平及支架内血栓的发生率,提示苦碟子注射液发挥作用的靶点为MMPs和TXB2。

Objective To investigate the effects of Kudiezi injection on stent thrombosis and the levels of matrix metalloproteinase（MMPs） and thromboxane B2（TXB2）in elderly patients with percutaneous coronary intervention（PCI）,and investigate the mechanism of Kudiezi on the decrease of stent thrombosis.Methods Forty elderly patients were divided into two groups（Kudiezi group and control group） after PCI.Kudiezi were administered into patients in Kudiezi group and the patients in control group were treated with regular medication.The angioraphic and clinic follow-up outcomes of 40 elderly patients with PCI there retrospectively analyze.Stent thrombosis（ST）was confirmed by angiography.The levels MMPs and TXB2 in Kudiezi group（n=20） and control group（n=20） were determined before stent implantation and after 6 months.Major cardiac events（restenosis,cardiac death,myocardiac infarction,revasculation）were observed during follow-up.Results The levels of MMPs and TXB2 in Kudiezi and control group decreased significantly after PCI.The levels of MMPs and TXB2 in Kudiezi group were less than that in control group after PCI.The levels of MMPs and TXB2 in all patients group were signifantly different between pre-procedure and post-procedure（P〈0.05）.Within 6 months of stent implantation,the occurrence of ST was less in Kudiezi group than that in control group（P〈0.05）.Conclusion Kudiezi injection can deminish the onset of stent thrombosis and decrease the levels of MMPs and TXB2.