摘要
目的探讨中药脑心通胶囊对冠状动脉临界病变冠心病患者炎症反应及远期预后的影响。方法采用随机、对照、前瞻性研究方法。选择240例冠状动脉临界病变(直径狭窄50%～70%)以心绞痛为首发症状的冠心病患者,随机分为常规治疗组(常规组)和脑心通胶囊治疗组(脑心通组)。两组均给予常规西药治疗及其他对症处理,脑心通组加服脑心通胶囊,疗程均为12个月。观察治疗后心血管事件的发生率;测定治疗前后患者血清炎性因子[IL-6、TNF-α、高敏C反应蛋白(hs-CRP)]和基质金属蛋白酶-9(MMP-9)水平;监测血压,血脂,血糖以及心、肝、肾功能。结果治疗12个月后,脑心通组心绞痛发作和因急性冠脉综合征(ACS)发作而住院例数均明显低于常规组(分别为6.67%vs15.83%,4.17%vs10.83%,P<0.05)。治疗前两组血清IL-6、TNF-α、hs-CRP及MMP-9水平比较,差异均无统计学意义(P>0.05);治疗12个月后,两组患者IL-6、TNF-α、hs-CRP、MMP-9水平均较本组治疗前明显降低(P<0.05),且脑心通组血清IL-6、TNF-α、hs-CRP及MMP-9水平较常规组明显降低(P<0.05)。影响患者心绞痛发作的Logistic多元回归分析发现,治疗后MMP-9水平和治疗后IL-6水平是影响心绞痛复发的独立危险因素。结论脑心通胶囊可以减轻炎症反应,长期服用可减少冠状动脉临界病变冠心病患者的心绞痛复发及ACS发作。治疗后MMP-9和IL-6水平是影响心绞痛复发的独立危险因素。
Objective To study the effects of Naoxintong Capsule （NC） on the inflammation and long-term prognosis in the borderline lesion coronary heart disease patients. Methods A total of 240 coronary heart disease patients with angina symptoms and accompanied with borderline lesion coronary heart disease （with the diameter stenosis in critical 50% -70%） by means of coronary angiography or multislice computed tomography coronary angiography were recruited. These patients were randomly assigned to the conventional treatment group （including nitrate, beta blockers, anti-platelet, anticoagulation, angiotensin converting enzyme inhibitors, and so on） and the NC treatment group （treated the same way as those for the conventional treatment group and NC）. All patients were treated for 12 months. The occurrence of cardiovascular events was observed after treatment. The inflammatory factors in serum E interleukin 6 （ I L-6）, tumor necrosis factor alpha （TNF-cc）, and high sensitive C reaction protein （hs-CRP）l, matrix metalloproteinases-9 （MMP-9）, blood lipids and blood sugar, liver and kidney functions were measured before and after treatment. Results After 12 months of treatment, the incidence of angina pectoris patients （6.67% vs 15. 83%, P 〈 0. 05） and hospitalization due to acute coronary syndrome （ACS） attacks （4. 17% vs 10.83%） was significantly lower in the NC treatment group than in the conventional treatment group. There was no statistical difference in the serum levels of IL-6, TNF-a, hs-CRP, and MMP-9 be- tween the two groups before treatment （P〉0.05）. After 12 months of treatment, serum levels of IL-6, TNF-c~, hs-CRP, and MMP-9 were significantly lower when compared with before treatment in the same group （P〈0.05）. Besides, the serum levels of IL-6, TNF-cc, hs-CRP, and MMP-9 were significantly lower in the NC group than in the conventional treatment group （ P 〈 0.05）. By means of Logistic regression analysis we found that the post-treatment MMP-9 level and IL-6 level were independent risk factors influencing the recurrence of an- gina pectoris. Conclusions NC could alleviate the inflammation. Long-term administration of NC could reduce the recurrence of angina pectoris and decrease the incidence of ACS attack in borderline lesion coronary heart dis- ease patients, The post-treatment MMP-9 level and IL-6 level were independent risk factors influencing the recur- rence of angina pectoris.
出处
《中国中西医结合杂志》
CAS
CSCD
北大核心
2012年第5期607-611,共5页
Chinese Journal of Integrated Traditional and Western Medicine
关键词
冠状动脉
临界病变
斑块
炎症
中药
脑心通胶囊
coronary artery
borderline lesion
atherosclerosis plaque
inflammation
Chinese materia medica
Naoxintong Capsule
