冠脉支架术后不同活血化瘀注射剂的干预对照研究

Comparative study of differentblood- activiating and stasis- dissolving injection interventions after coronary stenting

目的比较冠状动脉支架术后丹红注射液与葛根素注射液的临床疗效和安全性。方法我院2011年7月至2013年10月行冠状动脉支架术73例患者,随机分为葛根素注射液组(葛根组)37例,丹红注射液组(丹红组)36例,两组患者均以常规抗血小板治疗。以心电图变化、血液流变学指标以及随访12个月时再狭窄、死亡、出血等严重心血管事件(TSCE)风险等评价。结果与葛根组比较,丹红组的血液流变学指标较葛根组明显降低(P<0.05),心电图ST段下降导联数及压低数值总和比较,两组无统计学差异(P>0.05);12个月随访发现,丹红组再狭窄2例(5.5%),出血2例(5.5%),输血1例(2.8%),TSCE发生率为13.8%;葛根组再狭窄5例(13.5%),输血1例(2.8%),无出血患者,TSCE发生率为16.3%,两组均无死亡患者。结论冠状动脉支架术后两种注射液治疗的均疗效确切,丹红注射液再狭窄率低,但有出血风险,而葛根注射液安全性高同时再狭窄率也高,临床应根据患者病情灵活选用。

Objective： To evaluate the efficacy and safety of Danhong Injection and Puerarin Injection after coronary stent. Methods： 73 patients carried out coronary stent from July 2011 to Octobor 2013 were randomly divided into Puerarin Injection group（ Group Puerarin,37 cases） and Danhong Injection（ Group Danhong,36 cases）. Patients in two groups were treated with conventional antiplatelet therapy assessed by TSCE（ Total serious cardiovascular events,TSCE） risk of electrocardiogram changes,blood rheology indexes,12 months follow- up of restenosis,death,hemorrhage,et al. Results：Compared with Group Puerarin,blood rheology indexes in Group Danhong were significantly decreased（ P〈 0. 05）. The decreased leads of ST segments and the sum of depressed number had no diffirences in two groups（ P〈 0. 05）; After 12 months follow up in Group Danhong,2 cases had restenosis（ 5. 5%）,2 cases hemorrhage（ 5. 5%）,1 cases blood transfusion（ 2. 8%）,the incidence of TSCE was 13. 8%; In Group Puerarin,5 cases restenosis（ 13. 5%）,1 cases hemorrhage（ 2. 8%）,no hemorrhage,the incidence of TSCE was 16. 3%; There were no death in two groups. Conclusion： The efficacy of two kinds of injection therapy after coronary artery stenting are both exact. There is low restenosis rate in Group Danhong,but had a risk of bleeding,whereas there is high restenosis rate in Group Puerarin with high safty. Clinical choice should be flexible according to the condition of patients.