脉血康胶囊联合替格瑞洛治疗急性冠脉综合征的临床疗效及其对患者血清炎性因子水平、血脂的影响

Clinical Effect of Maixuekang Capsule Combined with Ticagrelor on Acute Coronary Syndrome and the Impact on Serum Inflammatory Cytokines Levels and Blood Liquids Index

目的观察脉血康胶囊联合替格瑞洛治疗急性冠脉综合征(ACS)的临床疗效,探讨其对患者血清炎性因子水平、血脂的影响。方法选取枣庄矿业集团中心医院心脏大血管科2014—2015年收治的ACS患者96例,按照随机数字表法分为对照组和观察组,每组48例。对照组患者给予替格瑞洛治疗,观察组患者在对照组基础上联合脉血康胶囊治疗;两组患者均持续治疗14 d。比较两组患者临床疗效,治疗前后血清炎性因子〔C反应蛋白(CRP)、白介素18(IL-18)、白介素10(IL-10)〕水平、血脂指标〔低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、总胆固醇(TC)、三酰甘油(TG)〕、心功能指标〔左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)〕及治疗期间不良反应发生情况。结果观察组患者临床疗效优于对照组(P<0.05)。治疗前两组患者血清CRP、IL-18、IL-10水平比较,差异无统计学意义(P>0.05)。治疗后观察组患者血清CRP、IL-18水平低于对照组,血清IL-10水平高于对照组(P<0.05);两组患者治疗后血清CRP、IL-18水平低于治疗前,血清IL-10水平高于治疗前(P<0.05)。治疗前两组患者血清LDL-C、HDL-C、TC、TG水平比较,差异无统计学意义(P>0.05)。治疗后观察组患者血清HDL-C水平高于对照组,血清LDL-C、TC、TG水平低于对照组(P<0.05);两组患者治疗后血清HDL-C水平高于治疗前,血清LDL-C、TC、TG水平低于治疗前(P<0.05)。治疗前两组患者LVEF、LVESD、LVEDD比较,差异无统计学意义(P>0.05)。治疗后观察组患者LVEF、LVESD、LVEDD高于对照组(P<0.05);两组患者治疗后LVEF、LVESD、LVEDD高于治疗前(P<0.05)。两组患者治疗期间均未出现严重不良反应。结论脉血康胶囊联合替格瑞洛治疗ACS的临床疗效确切,可有效改善患者微炎症状态、血脂代谢及心功能,且安全性较高。

Objective To observe the clinical effect of maixuekang capsule combined with ticagrelor on acute coronary syndrome,to investigate the impact on serum inflammatory cytokines levels and blood liquids index. Methods From 2014 to2015,a total of 96 patients with acute coronary syndrome were selected in the Department of Heart and Macrovascular Disease,the Central Hospital of Zaozhuang Mining Group,and they were divided into control group and observation group according to random number table,each of 48 cases. Patients of control group were given ticagrelor,while patients of observation group were given maixuekang capsule combined with ticagrelor; both groups continuously treated for 14 days. Clinical effect, serum inflammatory cytokines（ including CRP,IL-18 and IL-10） levels,blood liquids index（ including LDL-C,HDL-C,TC and TG） and index of cardiac function（ including LVEF, LVESD and LVEDD） before and after treatment, and incidence of adverse reactions during the treatment were compared between the two groups. Results The clinical effect of observation group was statistically significantly better than that of control group（ P〈0. 05）. No statistically significant differences of serum level of CRP,IL-18 or IL-10 was found between the two groups before the two groups（ P〉0. 05）. After treatment,serum levels of CRP and IL-18 of observation group were statistically significantly lower than those of control group,while serum level of IL-10 of observation group was statistically significantly higher than that of control group（ P〈0. 05）; serum levels of CRP and IL-18 of the two groups were statistically significantly lower than those before treatment, while serum IL-10 of the two groups was statistically significantly higher than that before treatment,respectively（ P〈0. 05）. No statistically significant differences of serum level of LDL-C,HDL-C,TC or TG was found between the two groups（ P〉0. 05）. After treatment,serum HDL-C level of observation group was statistically significantly higher than that of control group,while serum levels of LDL-C,TC and TG of observation group were statistically significantly lower than those of control group（ P〈0. 05）; serum HDL-C level of the two groups was statistically significantly higher than that before treatment,respectively,while serum levels of LDL-C,TC and TG of the two groups were statistically significantly lower than those before treatment（ P〈0. 05）. No statistically significant differences of LVEF,LVESD or LVEDD was found between the two groups（ P〉0. 05）. After treatment,LVEF,LVESD and LVEDD of the two groups were statistically significantly higher than those of control group（ P〈0. 05）; LVEF, LVESD, LVEDD of observation group were statistically significantly higher than those before treatment（ P〈0. 05）. No one of the two groups occurred any severe adverse reactions during the treatment. Conclusion Maixuekang capsule combined with ticagrelor has certain clinical effect in treating acute coronary syndrome,can effectively relieve the micro- inflammatory state,adjust the blood lipid metabolism and improve cardiac function,with relatively high safety.