芪参益气滴丸对冠状动脉介入术后炎症因子及心脏不良事件的影响

Influences of Qishen Yiqi Gutta Pills on inflammatory factors and major adverse cardiovascular events after percutaneous coronary intervention

目的观察芪参益气滴丸对急性冠脉综合征(ACS)患者经皮冠状动脉介入术(PCI)后炎症因子及主要不良心脏事件(MACE,包括复发心绞痛、急性心肌梗死、严重心律失常、心力衰竭、冠心病死亡)影响。方法纳入60例行PCI的ACS患者,随机分为常规治疗组(n=30)和芪参益气滴丸联合常规治疗组(芪参组,n=30),采用酶联反应吸附法(ELISA法)比较两组术后24h和术后6个月血清高敏C反应蛋白(hs-CRP)、可溶性CD40配体(sCD40L)及基质金属蛋白酶-9(MMP-9)水平变化,并比较两组6个月MACE事件发生率。结果术后24h两组血清hs-CRP、sCD40L和MMP-9水平均无统计学差异(P>0.05);6个月后,两组hs-CRP、sCD40L和MMP-9水平分别是3.18±0.71mg/l、5.86±2.01ng/dl和240.56±60.6ng/dl。与对照组相比,芪参组血清hs-CRP、sCD40L及MMP-9均明显降低,差异有统计学意义(P<0.05),随访6个月,芪参组MACE发生率较对照组更低(13.33%vs.26.67%,P<0.05),且差异有统计学意义。结论芪参益气滴丸可降低介入术后炎症因子hs-CRP、SCD40L和MMP-9的水平,同时降低MACE近期发生率。

Objective To observe the influences of Qishen Yiqi Gutta Pills on inflammatory factors and major adverse cardiovascular events （ MACE ） in the patients with acute coronary syndrome （ ACS ） after percutaneous coronary- intervention （ PCI ） . Methods ACS patients （ rt=60 ） were randomly divided into routine therapy group （ control group ） and Qishen Yiqi Gutta Pills combining routine therapy group （ combining group, each n=30 ） . The changes of high-sensitivity C-reactive protein （ hs-CRP ） , soluble CD40 ligand （ sCD40L ） and matrix metalloproteinase-9 （ MMP-9 ） were cmnpared between two groups by using enzyme-linked immunosorbent assay （ EL1SA ） 24 hours and 6 months after PCI. The incidence rate of MACE （ including severe arrhythmia, relapsing angina pectoris, non-fatal myocardial infarction and target vessel revascularization ） and mortality were compared between two groups after 6 months. Results The levels of hs-CRP, sCD40L and MMP-9 had no statistical difference between two groups （P〉O.05） 24 hours after PCI. After 6 months, the levels of hs-CRP, sCD40L and MMP-9 were, respectively, 3.18± 0.7hng/1, 5.86 ± 2.01 ng/dl and 240.56 ± 60.6 ng/dl. Compared with control group, the levels of hs-CRP, sCD40L and MMP-9 decreased significantly in combining group （ P〈0.05 ） , and the incidence rate of MACE was lower than that in control group （ 13.33% vs. 26.67%, P〈0.05 ） after 6 months. Conclusion Qishen Yiqi Gutta Pills can reduce the levels of hs-CRP, sCD40L and MMP-9 and short-term incidence rate of MACE after PCI.