参麦注射液对急性冠脉综合征患者血清黏附分子与C反应蛋白表达水平干预作用

Effect of Shenmai injection on serum adhesion molecule and C-reactive protein in patients with acute coronary syndrome

目的探讨参麦注射液对急性冠脉综合征(ACS)患者血清黏附分子与C反应蛋白(CPR)表达水平的干预作用。方法选取辽宁中医药大学附属第二医院心内二科诊治的ACS患者74例,随机分为常规组与观察组。常规组37例,予以常规处理,行经皮冠状动脉介入(PCI)术,术前服用150 mg阿司匹林、300 mg氯吡格雷,1次/d,持续用药7 d;术后服用100 mg阿司匹林,1次/d。观察组37例,在常规组基础上,术后加用参麦注射液40 ml于5%葡萄糖溶液250 ml稀释后,1次/d静点。两组患者均术后连续用药8周。比较两种治疗方法的临床疗效、CPR、白细胞介素-6(IL-6)、肿瘤坏死因子α(TNF-α)、血管内皮细胞黏附分子-1(s VCAM-1)、可溶性细胞间黏附分子-1(s ICAM-1)、临床心电图标准以及不良事件发生情况。结果治疗后,与治疗前比较,两组患者CPR、IL-6、TNF-α、s ICAM-1、s VCAM-1、心肌梗死发作次数、持续时间以及ST段下移水平均降低,差异有统计学意义(P<0.05)。观察组治疗有效率为94.60%,高于常规组的72.97%,差异有统计学意义(P<0.05)。观察组CPR、IL-6、TNF-α、s ICAM-1、s VCAM-1、心肌梗死发作次数、持续时间以及ST段下移水平均低于常规组,差异均有统计学意义(P<0.05)。结论参麦注射液对ACS患者有较好的临床疗效,能有效改善心功能,降低血清黏附分子与CPR的表达水平,对临床治疗ACS具有重要意义。

Objective To investigate the effect of Shenmai injection on the levels of serum adhesion molecules and C-reactive protein（CPR）in patients with acute coronary syndrome（ACS）. Methods A total of 74 ACS patients were randomly divided into the control group and the study group,37 cases in each group. Patients in the control group were treated with routine western medicine,percutaneous coronary intervention（ PCI）,150 mg of aspirin and 300 mg of clopidogrel before surgery,1 time/day,insisted for 7 days;postoperation,orally taking 100 mg of aspirin,1 time/day. Patients in the study group were on the basis of the control group,postoperation adding the Shenmai injection of 40 ml into 5% glucose solution 250 ml diluted,1 time/day intravenous drip. The patients in both groups were treated for continuous 8 weeks. The clinical effects,CPR,interleukin-6（ IL-6）,tumor necrosis factor-α（ TNF-α）,vascular endothelial cell adhesion molecule-1（ s VCAM-1）,Soluble intercellular adhesion molecule-1（ s ICAM-1） clinical ECG criteria and adverse events in the two therapeutic regimens were analyzed and compared. Results After treatment,the levels of CPR,IL-6 and TNF-α,serum s ICAM-1,s VCAM-1,the number of myocardial infarctions,duration and ST segment depression water level in the two groups were lower than those before treatment,and the difference had statistically significance（ P〈0. 05）. The effective rate in study group was 94. 60%,which was higher than that in the control group 72. 97%,the difference has statistically significance（ P〈0. 05）. The levels of CPR,IL-6 and TNF-α,serum s ICAM-1,s VCAM-1,the number of myocardial infarctions,duration and ST segment depression water level in the study group were all lower than those in the control group,the difference had statistically significance（ P〈0. 05）.Conclusion Shenmai injection has a good clinical curative effect on patients with acute coronary syndrome,which can improve cardiac function,reduce serum adhesion molecules and C-reactive protein levels,and has great significance in clinical treatment of acute coronary syndrome.