参红通络颗粒对稳定型心绞痛患者经皮冠状动脉介入术围术期炎性因子及心肌损伤影响的研究

The influences of the Shenhong Tongluo granules on inflammatory factors and myocardial injury in SAP patients during PCI perioperative period

目的:通过对经皮冠状动脉介入术(Percutaneous Coronary Intervention,PCI)前及PCI后18~24 h外周血清肿瘤坏死因子-α(Tumor Necrosis Factor-α,TNF-α)、白细胞介素-6(Interleukin-6,IL-6)、超敏C反应蛋白(High-sensitivity C-reactive Protein,hs-CRP)及肌钙蛋白I(Troponin I,cTnI)和肌酸激酶同工酶(Creatine Kinase-MB,CK-MB)表达水平变化的比较,客观评价参红通络颗粒减轻血清炎性因子表达水平及减轻心肌损伤的临床疗效。方法:将长春中医药大学附属医院心病中心2019年1月-2020年1月符合纳入标准的72例入院患者随机分成治疗组36例及对照组36例,治疗组给予西药常规治疗,术前7 d加用参红通络颗粒,对照组仅给予西医常规治疗。分别于入院后及PCI后18~24 h采集外周静脉血并检测其TNF-α、IL-6、hsCRP、c TnI、CK-MB水平。结果:与术前相比,对照组TNF-α、IL-6、hs-CRP、cTnI、CK-MB水平均有所上升,差异有统计学意义(P <0.05),治疗组IL-6水平降低,hs-CRP、cTnI、CK-MB水平有所升高,差异有统计学意义(P <0.05),TNF-α水平与术前差异无统计学意义(P> 0.05),两组数据变化趋势表明PCI术可引起炎性因子升高并造成心肌损伤性改变。PCI术后两组患者各数据经分析,差异有统计学意义(P <0.05),且治疗组炎性因子水平及心肌标志物水平低于对照组,表明治疗组在降低炎性因子及心肌损伤标志物方面优于对照组。结论:参红通络颗粒联合西医常规治疗对于降低PCI术后炎性因子水平,减少心肌损伤疗效优于单纯西医常规治疗,值得临床应用。

Objective: By comparing the expression levels of TNF-α, IL-6, hs-CRP, cTnI and CK-MB in serum before PCI and 18 ~ 24 hours after PCI, the clinical effects of the Shenhong Tongluo granules(参红通络颗粒) on reducing serum inflammatory factor expression and myocardial injury were evaluated objectively. Methods: 72 patients were divided into the treatment group(36 cases) and the control group(36 cases). The treatment group was treated with Western medicine, the Shenhong Tongluo granules were added 7 days before operation, and the control group was only treated with Western medicine. Results: In the control group, compared with before operation, the TNF-α, IL-6, hs-CRP, cTnI and CK-MB levels in the groups were all increased, with statistically significant differences(P<0.05). In the treatment group, compared with before operation, IL-6 level was decreased, hs-CRP, cTnI, and CK-MB levels were all increased, with statistically significant differences(P<0.05), and TNF-α level was not statistical different. The trend of data changes in the groups showed that PCI could increase inflammatory factors and cause myocardial injury. After PCI, the data in the groups was statistically significant(P<0.05);and the levels of inflammatory factors and myocardial markers in the treatment group were lower than those in the control group, indicating that the treatment group was better than the control group in reducing inflammatory factors and myocardial damage markers. Conclusion: The Shenhong Tongluo granules plus conventional Western medicine is better than conventional Western medicine in reducing inflammatory factors levels and myocardial injury after PCI, and is worthy of promotion.