中西医结合对稳定冠心病患者颈动脉粥样硬化斑块的疗效及IMT、Smax的变化研究

Study on the Effect of Integrated Traditional Chinese and Western Medicine in Stabilizing Carotid Atherosclerotic Plaques for Patients with Coronary Heart Disease and the Change of IMT and Smax

目的:分析中西医结合对稳定冠心病患者颈动脉粥样硬化斑块的疗效及颈动脉内膜内-中膜厚度(IMT)、斑块在横切面上最大面积(Smax)的变化。方法:选取我院于2017年3月~2018年11月收治的60例稳定冠心病合并颈动脉粥样硬化斑块患者的临床资料进行分析,分为两组。对照组采用西医治疗,观察组采用中西医结合治疗,分析两组患者治疗后的临床疗效。结果:两组患者治疗前巨噬细胞游走抑制因子(MIF)、血管内皮细胞生长因子(VEGF)、基质金属蛋白酶~9(MMP-9)、炎症因子水平、c-Jun蛋白表达组间比较,差异不具有统计学意义(P>0.05)。观察组患者治疗后MIF、VEGF、MMP-9、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)水平、c-Jun蛋白表达低于对照组(P<0.05)。两组患者治疗前颈动脉斑块变化、总动脉血流动力学水平组间比较,差异不具有统计学意义(P>0.05)。观察组患者治疗后IMT、Smax、斑块厚度、斑块数量、收缩期血流速(PSV)、舒张期血流速(EDV)水平低于对照组(P<0.05)。结论:中西医结合治疗稳定冠心病患者颈动脉粥样硬化斑块,能够降低MIF、VEGF、MMP-9、炎性因子水平,降低IMT、缩小斑块面积,改善血流动力学水平。

Objective:To analyze the efficacy of integrated traditional Chinese and western medicine in stabilizing carotid atherosclerotic plaques for patients with coronary heart disease and the change of the largest area(Smax)of carotid endometrial-media thickness(IMT)plaques on the transverse plane.Methods:60 patients with stable coronary heart disease and carotid atherosclerotic plaque admitted to our hospital from March 2017 to November 2018 were selected for clinical data analysis.They were divided into two groups:the controlled group was treated with western medicine,the observation group was treated with integrated traditional Chinese and western medicine,and the clinical efficacy of the two groups after treatment was analyzed.Results:2 groups of patients before treatment of macrophage migration inhibitory factor(MIF),vascular endothelial growth factor(VEGF),matrix metalloproteinases-9(MMP-9)inflammatory factors level c-Jun protein expression comparison between groups,no statistically significant difference(P>0.05)in observation group of patients after treatment MIF VEGF,MMP-9 hypersensitive c-reactive protein(hs-CRP),tumor necrosis factor alpha(TNF-α),interleukin 6(IL-6),c-Jun protein expression level was lower than the controlled group(P<0.05).The difference between the two groups was not statistically significant(P>0.05).After treatment,IMT Smax plaque thickness,plaque number,systolic blood flow rate(PSV)and diastolic blood flow rate(EDV)in the observation group were lower than those in the controlled group(P<0.05).Conclusion:The combination of Chinese and western medicine can stabilize carotid atherosclerotic plaques in patients with coronary heart disease,reduce the level of MIF,VEGF,MMP-9 inflammatory factor,reduce IMT,reduce plaque area,and improve hemodynamic level.