疏血通对女性无介入治疗指征急性冠脉综合症患者内皮功能的影响

The Impact of Shuxuetong Injection to Endothelial Function in Acute Coronary Syndrome Female Patients Without Indications for Interventional Treatment

目的探讨疏血通对无介入治疗指征女性急性冠脉综合症(ACS)患者内皮功能的影响。方法 ACS患者60例,全部经冠脉造影显示冠脉无显著局限性病变或病变呈弥漫性,无支架植入术治疗指征,随机分为常规治疗组和疏血通治疗组两组,每组30例,并选择同期健康体检者30例作为健康对照组。常规对照组给予常规治疗,按冠心病二级预防及ACS治疗指南用药;疏血通治疗组在常规治疗的基础上加用疏血通注射剂10ml/d,疗程10d。检测治疗前后内皮功能及血浆内皮素(ET1)、血栓烷B2(TXB2)、6-酮-前列腺素(6-keto-PGF1a)的含量,观察疏血通治疗组与常规治疗组患者的不良反应情况。结果经10d治疗后,两组内皮功能均明显提高,ET1、TXB2有所下降,6-keto-PGF1a有显著性升高,且疏血通治疗组较常规治疗组更为明显;住院期间心血管事件发生率差异无统计学意义。结论提示疏血通可显著改善无支架植入术治疗指征的女性ACS患者的血管内皮功能,且有改善近期预后的倾向。

Objective To explore the effect of Shuxuetong injection on the prognosis,endothelial function,and cardiovascular event of acute coronary syndrome female patients（ACS）without indications for interventional treatment.Methods 60 ACS female patients without significant coronary artery stenosis or indiscriminate lesion of coronary artery were randomly divided into two groups,traditional treatment group and Shuxuetong treatment group（each n=30）.At the same time,30 healthy individuals were served as healthy control group.Traditional treatment group was given standard therapy which followed the guidelines of ACS.In addition to standard therapy of traditional treatment group,Shuxuetong treatment group was given Shuxuetong injection（10 ml/d）for ten days.The changes of brachial artery flow-mediated dilation（FMD）were detected through high-resolution ultrasonography.The levels of serum endothelins：ET1,TXB2,6-keto-PGF1a and vWF（ET）were tested before and after the treatment.The incidence rates of unstable angina pectoris and acute myocardial infarction,and mortality during the periods of hospitalization were compared between traditional treatment group and Shuxuetong treatment group.Results After 10-day treatment,FMD and 6-keto-PGF1a were significantly increased and ET1 and TXB2 levels were significantly decreased in Shuxuetong treatment group than those in traditional treatment group.No statistically significant difference was found in the incidence rates of unstable anginapectoris and acute myocardial infarction,and mortality during the hospitalization period between traditional treatment group and Shuxuetong treatment group.Conclusions The results suggest that Shuxuetong can significantly increase FMD and reduce ET1 and TXB2 levels in ACS female patients without indications for interventional treatment and also seems to improve the early prognoses of the patients.