冠状动脉再通膏对不稳定型心绞痛患者斑块稳定性、细胞凋亡因子及凝血指标变化的影响

Influence of Coronary Artery Recanalization Paste on Plaque Stability,Apoptotic Factors and Coagulation Indicators in Patients with Unstable Angina Pectoris

目的:观察冠状动脉再通膏治疗不稳定型心绞痛的临床疗效及对患者心肌细胞凋亡、凝血功能和斑块稳定性的影响。方法:将150例不稳定型心绞痛患者随机分为对照组和观察组,每组各75例。对照组患者采用常规西药治疗,观察组患者在对照组的基础上加用冠状动脉再通膏。比较两组患者的临床疗效,检测两组患者治疗前后细胞凋亡相关因子(s Fas、s Fas L含量和Fas/Apol活性)、斑块稳定性指标(斑块峰值强度、斑块增强强度、达峰时间、斑块起始增强时间和平均渡越时间)和凝血功能指标[凝血酶原时间(prothrombin time,PT)、部分活化凝血活酶时间(activated partial thromboplastin time,APTT)、凝血酶时间(thrombin time,TT),血浆纤维蛋白原(plasma fibrinogen,Fib)和D-二聚体(D-Dimer D-D)]水平。结果:观察组有效率为92.00%,对照组有效率为74.67%,两组患者临床疗效比较,差异具有统计学意义(P<0.05)。两组患者治疗后s Fas、s Fas L和Fas/Apol均下降,并且观察组低于对照组,差异有统计学意义(P<0.05)。两组患者斑块峰值强度、斑块增强强度、达峰时间、斑块起始增强时间和平均渡越时间均降低,并且观察组斑块峰值强度、斑块增强强度、达峰时间、斑块起始增强时间和平均渡越时间低于对照组,差异有统计学意义(P<0.05)。两组患者PT、APTT、TT均延长,观察组PT、APTT、TT高于对照组;两组患者Fib、D-D均降低,并且观察组Fib、D-D少于对照组,差异有统计学意义(P<0.05)。结论:冠状动脉再通膏治疗不稳定型心绞痛患者疗效显著,作用机制可能与其通过改善患者凝血功能,下调细胞凋亡相关因子的水平,减少细胞凋亡,提高不稳定斑块的稳定性有关。

Objective：To observe the clinical efficacy of Coronary Artery Recanalization Paste in patients suffering from unstable angina pectoris（ UAP） and the influence on participant＇s apoptotic factors,coagulation indicators,and plaque stability. Methods：A total of UAP 150 patients were randomly divided into control group and observation group,with 75 cases in each group. In the control group,conventional Western drug therapy was used,while in the observation group,on the basis of the control group,Coronary Artery Recanalization Paste was added. The clinical efficacy was compared and the factors in cell apoptosis such as the content of s Fas and s Fas L,and activity of Fas to Apol,indicators of plaque stability like plaque peak intensity,plaque enhanced intensity,time to peak,plaque initial enhanced time,and mean transit time,and coagulation indicators including prothrombin time（PT）,activated partial thromboplastin time（APTT）,thrombin time（TT）,plasma fibrinogen（Fib）,and D-dimer（D-D） were detected before and after treatment in the two groups. Results：The effectiveness rate in the observation group was 92. 00%,and74. 67% in the control group with a significant difference after comparison（ P〈0. 05）. After therapy,the indexes of s Fas,s Fas L,and the ratio of Fas to Apol were all decreased,and the decrease in the observation group was more remarkable with statistical significance（ P〈0. 05）. The indicators of plaque peak intensity,plaque enhanced intensity,time to peak,plaque initial enhanced time,and mean transit time were all decreased in the two groups,and decrease in the observation group was more significant compared to the control group（ P〈0. 05）. The PT,APTT,and TT were all prolonged,and these three indicators in the observation group were longer than those in the control group. Both Fib and D-D levels in the two groups were decreased,and the levels of these two indicators in the observation group were lower compared with those in the control group,which were displayed statistical significance（ P〈0. 05）. Conclusion：Coronary Artery Recanalization Paste can obtain a marked effect on UAP patients,and its potential mechanism might be related to improvement of coagulation function,down-regulation of apoptosis-related factors levels,reduction of cell apoptosis,and enhancement of the stability of unstable plaque.