脉血康胶囊对经皮冠状动脉介入治疗急性冠脉综合征患者血小板聚集率及其长期预后的影响

Effects of Maixuekang Capsule on the Platelet Aggregation Rate and Its Long-term Prognosis of Patients with Acute Coronary Syndrome under Percutaneous Coronary Intervention

目的研究脉血康胶囊对急性冠脉综合征患者行经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)术后二磷酸腺苷(adenosine diphosphate,ADP)介导血小板聚集率水平、高敏C-反应蛋白(highsensitive C-reactive protein,hs-CRP)浓度及长期预后的影响。方法连续入选2008年7月—2010年6月在北京安贞医院住院行PCI手术的急性冠脉综合征患者236例,随机分为常规治疗组(简称RTT组,120例)和脉血康治疗组(简称MKT组,116例),MKT组除常规药物治疗外,每天加用脉血康胶囊12粒,均连续治疗12个月。检测其术前、术后12h及术后30天ADP介导血小板聚集率水平和血清hs-CRP浓度,同时进行12个月临床随访,记录心脑血管事件的发生情况。结果与PCI手术前比较,急性冠脉综合征患者术后12hADP介导血小板聚集率水平和血清hs-CRP浓度明显增高,而经脉血康胶囊治疗30天后其显著降低,与RTT组比较,差异有统计学意义(P<0.05)。在12个月临床随访中,MKT组心脑血管事件的发生率显著低于RTT组(6.9%vs12.5%,P<0.01)。结论 ADP介导的血小板聚集功能在PCI手术后明显增强,是冠脉不良预后的一个因素。脉血康胶囊可降低PCI术后升高的血小板聚集率及hs-CRP浓度,并改善急性冠脉综合征患者的远期预后。

Objective To study the changes of adenosine diphosphate （ADP）-induced platelet aggregation rate, and evaluate the effects of Maixuekang Capsule （MC） on the platelet aggregation rate, high-sensitive C-reactive protein （hs-CRP） and the long-term prognosis in patients with acute coronary syndrome under percutaneous coronary intervention （PCI）. Methods Totally 236 inpatients with acute coronary syndrome under PCI, who successively re- ceived PCI from July 2008 to June 2010, were randomly assigned to the routine treatment group （ RFI＇, 120 cases） and the MC treatment group （MKT, 116 cases）. Besides routine medication, patients in the MKT group additionally took MC, 12 capsules daily for 12 successive months. The ADP-induced platelet aggregation rate and hs-CRP concentration were determined before PCI, 12 h and 30 days after PCI. In the meantime, the incidence of adverse cardio-/cerebro- vascular events was recorded during the twelve-month clinical follow-up. Results Compared with before PCI, ADP-in- duced platelet aggregation rate and the serum hs-CRP concentration were significantly higher 12 h after PCI （P 〈 0. 05）. They were significantly reduced after 30-day treatment of MC, showing statistical difference when compared with those in the RTT group （P〈0. 05）. In the 12-month follow-up, the incidence of adverse cardio-/cerebrovascu- lar events was significantly lower in the MKT group than in the RTT group （6. 9% vs 12. 5%, P〈0. 01 ）. Cenclu- siom ADP-induced platelet aggregation function was significantly elevated after PCI, which was a predictive factor of poor coronary events. MC improved the long-term prognosis of patients with acute coronary syndrome possibly through inhibiting the platelet aggregation rate and the hs-CRP concentration.