丹红注射液对经皮冠状动脉介入治疗后心肌炎症反应及冠状动脉血流的影响

Effects of Danhong injection （丹红注射液） on cardiac inflammatory reaction and coronary artery blood flow after selective percutaneous coronary artery intervention

目的 探讨丹红注射液对择期经皮冠状动脉（冠脉）介入治疗（PCI）术后患者心肌酶、炎症反应物及冠脉血流的影响.方法 将106例冠心病患者随机分为常规治疗组（51例）和丹红治疗组（55例）,50例健康体检者为对照组.两组患者均于PCI前给予常规治疗,丹红治疗组加用丹红注射液40 ml静脉滴注,每日1次,疗程为10 d.各组分别于治疗前及PCI后测定血中超敏C-反应蛋白（hs-CRP）、白细胞介素-6（IL-6）、纤维蛋白原（Fib）、纤溶酶原激活物抑制剂1（PAI-1）活性、D-二聚体（DD）、肌酸激酶同工酶（CK-MB）水平.结果 与健康对照组比较,两个冠心病组患者hs-CRP、IL-6、PAI-1明显增高（P〈0.05或P〈0.01）.与本组治疗前比较,丹红治疗组PCI术后IL-6、Fib、PAI-1、DD均降低,CK-MB升高（P〈0.05或P〈0.01）;而常规治疗组hs-CRP、IL-6、PAI-1、DD、CK-MB均明显升高（P〈0.05或P〈0.01）.与常规治疗组治疗后比较,丹红治疗组hs-CRP、IL-6、PAI-1、DD、CK-MB水平均明显降低,心肌梗死溶栓试验（TIMI）冠脉血流分级〈3级的比例明显减少（P〈0.05或P〈0.01）.结论 丹红注射液有抑制PCI后炎症反应、改善内皮功能、提高纤溶活性、稳定斑块的作用,并可作为PCI围手术期心肌保护的治疗措施.

Objective To explore the effects of Danhong injection （丹红注射液） on cardiac enzyme, inflammatory reactants and coronary artery blood flow after selective percutaneous coronary artery intervention （PCI）. Methods One hundred and six patients with coronary heart disease （CHD） were randomly divided into routine treated group （51 cases） and Danhong treated group （55 cases）. Fifty healthy volunteers were enrolled in a control group. The routine treatment was performed before PCⅡ in routine and Danhong treated groups, and the latter group was additionally given Danhong injection, intravenous drip 40 ml once per day, and the therapeutic course was 10 days. High sensitivity C-reactive protein （hs-CRP）, interleukin-6 （IL-6）, fibrinogen （Fib）, plasminogen activator inhibitor-1 （PAI-1）, D-dimer （DD） and creatine kinase isoenzyme （CK-MB） levels were measured before and after PCI in all the patients. Results Compared with healthy controls, the levels of hs-CRP, IL-6 and PAI-1 were significantly higher in patients with CHD （P〈0.05 or P〈0.01）. After 10-day treatment and PCI, IL-6, Fib, PAI-1 and DD were significantly decreased and CK-MB increased in Danhong group compared with those before treatment （P〈 0. 05 or P〈0.01）, but hs-CRP, IL-6, PAI-1, DD and CK-MB were significantly increased in routine group than those before treatment （P〈0.05 or P〈0. 01）. Compared with routine group after treatment and PCI, hs-CRP, IL-6, PAI-1, DD, CK-MB and the incidence of thrombolysis in myocardial infarction trial （TIMI） flow〈 3 were significantly decreased in Danhong group （P〈 0.05 or P〈 0. 01）. Conclusion Danhong injection possesses the effects of inhibiting inflammatory responses after PCI, improving endothelial function, increasing fibrinolytic activity and stabilizing atherosclerotic plaque, and can be used as a cardiac protective measure during peri-operative period of PCI in patients with CHD.