复方丹参滴丸防治冠心病经皮冠状动脉介入术后再狭窄的临床研究

Clinical research of compound Danshen dripping pills in preventing and curing coronary heart disease with restenosis after percutaneous coronary intervention

目的探讨复方丹参滴丸防治冠心病经皮冠状动脉介入术后再狭窄的作用。方法选择2012年7月—2013年8月收治的经皮冠状动脉介入术治疗的急性冠心病患者88例作为研究对象,随机分为对照组和治疗组各44例。对照组患者进行常规药物治疗,治疗组在对照组的基础上加用复方丹参滴丸,10丸/次,3次/d。4周为一个疗程,两组均治疗6个疗程。比较两组术后即刻、治疗6个疗程后血液流变学、Brawnwald心绞痛分级、缺血总负荷时间、冠状动脉内径相关参数、冠状动脉再狭窄及复发心绞痛情况。计量资料采用t检验,计数资料采用χ2检验,P<0.05为差异有统计学意义。结果治疗后,治疗组的低切全血黏度、中切全血黏度、高切全血黏度、红细胞聚集指数、Brawnwald心绞痛分级、缺血总负荷时间分别为(8.2±1.1)、(5.6±0.9)、(4.8±1.4)m Pa·s、(2.2±1.6)、(1.3±0.5)分、(165.4±77.6)min,明显低于对照组的(9.6±0.6)、(7.0±0.9)、(5.5±1.3)m Pa·s、(2.8±0.9)、(1.9±0.6)分、(293.2±79.5)min,差异均有统计学意义(均P<0.05)。治疗组纤维蛋白原、相关血管内径、病变最小内径(minimum luminal diameter,MLD)、狭窄病变最小横截面积(minimum luminal area,MLA)分别为(4.3±0.6)g/L、(3.0±0.4)、(2.1±0.3)、(4.3±0.8)mm,明显高于对照组的(3.3±0.8)g/L、(2.8±0.3)、(1.9±0.4)、(3.9±0.9)mm,差异均有统计学意义(均P<0.05)。对照组再狭窄率、复发率分别为27.3%、20.5%,均高于治疗组的9.1%、4.6%,差异均有统计学意义(均P<0.05)。结论复方丹参滴丸对冠状动脉介入术后的再狭窄、再复发心绞痛有积极的预防作用。

Objective To investigate the effects of restenosis in coronary heart disease patients by compound Danshen dripping pills after percutaneous coronary intervention. Methods 88 patients with acute coronary disease from July 2012 to August 2013 were selected and treated with percutaneous coronary intervention, randomly divided into control group and treatment group（n=44）.Patients in the control group were treated with routine drug therapy,patients in the treatment group were added compound Danshen dripping pills on the basis of control group,10 pills/time,3 times/d.A treatment course was four weeks,the two group were treated four six treatment course.The condition of blood rheology, brawnwald angina classification, time of total ischemic burden,coronary diameter related parameters, coronary restenosis and recrudescent angina pectoris at immediate after operation and after six treatment course were compared between two groups.Results After treatment,the low shear whole blood viscosity, middle shear whole blood viscosity, high shear whole blood viscosity, erythrocyte aggregation index, brawnwald angina classification, time of total ischemic burden in treatment group were（8.2±1.1）,（5.6±0.9）,（4.8±1.4）m Pa·s,（2.2±1.6）,（1.3±0.5）points,（165.4±77.6）min,those of the control group were（9.6±0.6）,（7.0±0.9）,（5.5±1.3）m Pa·s,（2.8±0.9）,（1.9±0.6）points,（293.2±79.5）min,the differences were statistically significant（all P〈0.05）. The fibrinogen, related blood vessel diameter, minimum luminal diameter（MLD）,minimum luminal area（MLA）of treatment group were（4.3±0.6）g/L,（3.0±0.4）,（2.1±0.3）,（4.3±0.8）mm,lower than those of the control group [（3.3±0.8）g/L,（2.8±0.3）,（1.9±0.4）,（3.9±0.9）mm],the differences were statistically significant（all P〈0.05）. The coronary restenosis rate, recrudescent angina pectoris rate in control group were 27.3%,20.5%, higher than those in the treatment group（9.1%,4.6%）, the differences were statistically significant（all P〈0.05）.Conclusion Compound Danshen dripping pills has positive effects to prevent restenosis, recurrence of pectoris after percataneous coronary intervention.