四君子汤加减联合阿司匹林治疗对急诊PCI术后预后的影响

Effects of Modified Sijunzi Decoction Combined with Aspirin Therapy on Patients' Prognosis after Emergency PCI

目的：观察急诊PCI（冠状动脉介入）术后患者四君子汤加减联合阿司匹林治疗对其预后的影响。方法：选取2014年3月~2015年2月我院心脏内科收治的86例急诊PCI术后患者为研究对象,随机数字表法分为两组各43例,对照组给予阿司匹林治疗,观察组给予四君子汤加减联合阿司匹林治疗,并进行为期一年的电话随访,观察治疗前、后两组心功能[左心室收缩末期内径（LVESD）、左心室舒张末期内径（LVEDD）、左心室射血分数（LVEF）]变化情况,并观察治疗前、后各指标[可溶性白介素2受体（s IL-2R）、超敏C-反应蛋白（hs CRP）、活化的T淋巴细胞（CD3^＋/HLA-DR^＋）]变化情况,同时观察两组治疗后再狭窄（RS）发生率。结果：治疗后观察组临床疗效88.37%较对照组69.77%显著高（P〈0.05）;治疗后两组LVESD、LVEDD分别均较治疗前显著减小,LVEF较治疗前显著增大,均差异显著（P〈0.05）,且治疗后观察组LVESD（48.92±7.11）mm、LVEDD（56.79±7.98）mm分别均较对照组减小显著,LVEF（45.36±4.39）%较对照组增大显著,均差异显著（P〈0.05）;治疗后观察组s IL-2R（620.13±452.21）U/ml、hs CRP（15.11±4.69）mg/L分别均较对照组降低显著,CD3^＋/HLA-DR^＋（10.89±4.39）%较对照组升高显著,均差异显著（P〈0.05）;治疗后观察组再狭窄发生率18.60%较对照组39.53%显著低（P〈0.05）。结论：四君子汤加减联合阿司匹林对急诊PCI术后患者的治疗,可显著改善术后患者心功能,显著降低s IL-2R、hs CRP,显著升高CD3^＋/HLA-DR^＋,显著降低术后再狭窄发生率。

Objective： To observe effects of Modified Sijunzi Decoction combined with aspirin therapy on patients＇ prognosis after emergency PCI（ coronary intervention）. Methods： 86 patients who received emergency PCI in cardiology department of our hospital from March 2014 to February 2015 were selected as the research objects,they were divided by random number table into two groups（ each 43cases）,the controlled group received aspirin therapy,the observation group received Modified Sijunzi Decoction combined with aspirin therapy,telephone follow-up was conducted in a year,changes of heart function [left ventricular end-systolic dimension（ LVESD）,left ventricular end-diastolic dimension（ LVEDD）,left ventricular ejection fraction（ LVEF） ]in the two groups before and after the treatment were observed,changes of various indexes [soluble interleukin 2receptor（ s IL-2R）,high sensitive C-reactive protein（ hs-CRP）,activated T lymphocytes（ CD3^＋/ HLA-DR^＋） ] before and after the treatment were observed,incidence of restenosis（ RS） after the treatment in the two groups was observed. Results： After the treatment,clinical efficacy of the observation group was 88. 37%,which was significantly higher than the controlled group（ 69. 77%）（ P〈0. 05）; LVESD and LVEDD of the two groups were significantly decreased compared with that before the treatment,LVEF was significantly increased compared with that before the treatment（ P〈0. 05）,after the treatment,LVESD（ 48. 92± 7. 11） mm,LVEDD（ 56. 79 ± 7. 98） mm in the observation group were significantly decreased compared with the controlled group,LVEF（ 45. 36 ± 4. 39） % was significantly increased compared with the controlled group（ P〈0. 05）; after the treatment,s IL-2R（ 620. 13 ± 452. 21） U / ml,hs-CRP（ 15. 11 ± 4. 69） mg / L in the observation group were significantly decreased compared with the controlled group,CD3^＋/ HLA-DR^＋（ 10. 89 ± 4. 39） % was significantly increased compared with the controlled group（ P〈0. 05）; after the treatment,incidence of restenosis in the observation group was 18. 60%,which was significantly lower than the controlled group（ 39. 53%）（ P〈0. 05）. Conclusion： Treating patients who received emergency PCI with Modified Sijunzi Decoction combined with aspirin can significantly improve postoperative heart function of patients,reduce s IL-2R and hs-CRP significantly,increase CD3^＋/ HLA-DR^＋significantly,reduce incidence of restenosis significantly.