丹红注射液对冠心病介入治疗后血瘀证患者不良心血管事件的影响

张涛; 陈晖; 黄家树; 沈涛; 宋昆鹏

doi:10.13422/j.cnki.syfjx.2018020186

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丹红注射液对冠心病介入治疗后血瘀证患者不良心血管事件的影响

临床 | 更新时间：2024-01-04

- 丹红注射液对冠心病介入治疗后血瘀证患者不良心血管事件的影响
- Effect of Danhong Injection on Adverse Cardiac Events After Percutaneous Coronary Intervention
- 中国实验方剂学杂志 2018年24卷第2期页码：186-191
- 作者机构：
- 作者简介：
- 基金信息：
  
  河南省教育厅重点科技项目（17A320054）
- DOI：10.13422/j.cnki.syfjx.2018020186
  中图分类号： R541.4
- 纸质出版日期：2018
- 稿件说明：
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张涛, 陈晖, 黄家树, 等. 丹红注射液对冠心病介入治疗后血瘀证患者不良心血管事件的影响[J]. 中国实验方剂学杂志, 2018,24(2):186-191.

ZHANG Tao, CHEN Hui, HUANG Jia-shu, et al. Effect of Danhong Injection on Adverse Cardiac Events After Percutaneous Coronary Intervention[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(2): 186-191.
张涛, 陈晖, 黄家树, 等. 丹红注射液对冠心病介入治疗后血瘀证患者不良心血管事件的影响[J]. 中国实验方剂学杂志, 2018,24(2):186-191. DOI： 10.13422/j.cnki.syfjx.2018020186.

ZHANG Tao, CHEN Hui, HUANG Jia-shu, et al. Effect of Danhong Injection on Adverse Cardiac Events After Percutaneous Coronary Intervention[J]. Chinese journal of experimental traditional medical formulae, 2018, 24(2): 186-191. DOI： 10.13422/j.cnki.syfjx.2018020186.

摘要

目的：探讨丹红注射液用于冠心病介入治疗后血瘀证患者不良心血管事件（MACE）的影响及抗炎、血管内皮功能和抗血栓形成作用机制。方法：将170例经皮冠状动脉介入治疗（PCI）后冠心病患者，采用区组随机按数字表法分为对照组和观察组各85例。对照组口服拜阿司匹林肠溶片，100 mg/次，1次/d；硫酸氢氧吡格雷片，75 mg/次，1次/d；阿托伐他汀钙片，20 mg/次，1次/d；美托洛尔缓释片，200 mg/次，2次/d；硝酸异山梨酯，5~10 mg/次，2次/d；观察组术后西医治疗措施同对照组，并于PCI术后给予丹红注射液，40 mL溶于5%葡萄糖250 mL，静脉滴注，2次/d；两组治疗14 d为一个疗程。记录两组近期（6个月内）MACE发生情况，测量治疗前后血清内皮素（ET），一氧化氮（NO），同型半胱氨酸（HCY），血管性假血友病因子（vWF）和肱动脉介导内皮依赖性舒张功能（FMD）等血管内皮功能指标；检测治疗前后超敏C反应蛋白（hs-CRP），肿瘤坏死因子（TNF）-α，白细胞介素-6（IL-6）和细胞间黏附分子-1（ICAM-1）等炎症因子水平；检测治疗前后纤维蛋白原（FIB），D-二聚体（D-D），血小板活化程度（血小板膜糖蛋白CD63，CD62 p和GPⅡb/Ⅲa受体复合物表达水平）和血液流变学，记录治疗前后6 min步行试验（6 MWT）和血瘀证评分及西雅图心绞痛量表（SAQ）评分。结果：观察组近期（6个月随访期）MACE的累积发生率为21.52%，低于对照组的37.46%（χ2=5.371，P<0.05）；治疗后观察组患者ET-1，vWF和Hcy水平均低于对照组，NO水平和FMD均高于对照组（P<0.01）；治疗后观察组患者血清hs-CRP，TNF-α，IL-6和ICAM-1水平均低于对照组（P<0.01）；观察组全血黏度（低切、高切）、血浆黏度和全血还原黏度等血液流变学指标改善均优于对照组（P<0.01）；观察组患者血清FIB，D-D，CD63，CD62 p和GPⅡb/Ⅲa水平均低于对照组（P<0.01）；观察组患者6 MWT多于对照组，血瘀证评分低于对照组，SAQ评分高于对照组（P<0.01）。结论：丹红注射液的使用能改善冠心病PCI术后患者的血管内皮功能，具有抗炎、改善血管内皮功能和抗血栓形的作用，减少了MACE的累积发生率，且改善了临床症状，提高了生活质量。

Abstract

Objective:To discuss the effect of Danhong injection on major adverse cardiovascular events (MACE) and its active mechanism on anti-inflammation

endothelial function and anti-thrombosis after the percutaneous coronary intervention (PCI). Method:One hundred and seventy patients with coronary heart disease after PCI were divided into control group and observation group by random number table. Patients in control group got aspirin enteric-coated tablets

100 mg/time

1 time/day. Clopidogrel hydrogen sulphate tablets

75 mg/time

1 time/day. Atorvastatin calcium tablets

20 mg/time

1 time/day. Metoprolol sustained-release tablets

200 mg/time

2 times/day. And isosorbide dinitrate

5-10 mg/time

2 times/day. In addition to the therapy of control group

patients in observation group also got 40 mL Danhong injection after PCI

which was dissolved in 250 mL 5% glucose injection for intravenous drip

2 times/day. A course of treatment was 14 days. Both groups' MACE were recorded before and after treatment. Endothelin (ET)

nitric oxide (NO)

homocysteine (HCY)

von willebrand factor (vWF) and flow mediated dilatation (FMD) were detected. And levels of hypersensitive C-reactive protein (hs-CRP)

tumor necrosis factor (TNF)-α

interleukin-6 (IL-6)

intercellular adhesion molecule-1 (ICAM-1)

fibrinogen (FIB)

D-dimer (D-D)

degree of platelet activation (expression of receptor complexes

such as platelet membrane glycoprotein CD63

CD62 p

GPⅡb/Ⅲa) and hemorheology were also detected. Scores of six-minute walking test (6 MWT)

blood stasis syndrome and Seattle angina questionnaire (SAQ) were scored. Result:The cumulative incidence in observation group was 21.52%

which was lower than 37.46% in control group (χ2=5.371

P<0.05). After treatment

levels of ET-1

vWF and Hcy in observation group were lower than those in control group

while levels of NO and FMD in observation group were higher than those in control group (P<0.01). And levels of hs-CRP

TNF-α

IL-6

ICAM-1

FIB

D-D

CD63

CD62 p and GPⅡb/Ⅲa in observation group were lower than those in control group (P<0.01). Full blood viscosity (low cut

high cut)

plasma viscosity and the whole blood reduced viscosity in observation group were alleviated more significantly than those in control group (P<0.01). And the 6 MWT in observation group was longer than that in control group. Score of blood stasis syndrome in observation group was lower than that in control group. Score of SAQ in observation group was higher than that in control group (P<0.01). Conclusion:Danhong injection can ameliorate vascular endothelial function of patients with coronary heart disease after PCI

with effects in resisting inflammation and thrombus

ameliorating vascular endothelial function

alleviating clinical symptoms

relieving cumulative incidence of MACE and improving quality of life.

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