目的探讨丹红注射液联合体外反搏治疗对急性冠脉综合征患者经皮冠状动脉介入术(PCI)后血浆炎症因子水平的影响。方法选取2012年11月~2014年8月在青岛大学附属医院因急性冠脉综合征行PCI手术,后转入青岛大学附属心血管病医院治疗的患者118例,其中男性68例,女性50例,按随机数表法分为Ⅰ组(n=38)、Ⅱ组(n=40)、Ⅲ组(n=40)。三组患者均给予常规治疗,Ⅰ组给予常规治疗,Ⅱ组在常规治疗基础上给予0.9%氯化钠250 ml或5%葡萄糖250 ml+丹红注射液40 ml静脉滴注1/日,Ⅲ组在常规治疗基础上给予0.9%氯化钠250 ml或5%葡萄糖250 ml+丹红注射液40 ml静脉滴注1/日及体外反搏治疗(1h/次,1/日),连续治疗14d。PCI术前1d、PCI术后1天(24h±2h)、治疗14d时测定高敏C反应蛋白(hs CRP)、血清细胞间粘附分子-1(ICAM-1)和血管细胞粘附分子-1(VCAM-1)。结果Ⅰ组有2例、Ⅱ组有1例、Ⅲ组有3例由于不能耐受体外反搏或病情加重中途退出试验。与PCI术前1d比较,PCI术后1d三组hs CRP、ICAM-1和VCAM-1均升高,差别有统计学意义(P<0.05);用药14d时,与Ⅰ组相比,Ⅱ组、Ⅲ组hs CRP、ICAM-1、VCAM-1较前降低,差异有统计学意义(P<0.05);与Ⅱ组相比,Ⅲ组hs CRP、ICAM-1、VCAM-1降低,差别有统计学意义(P<0.05)。结论丹红联合体外反博能降低急性冠脉综合征患者PCI术后的炎症因子水平。
Objective To investigate the influence of Danhong Injection combining external counterpulsation (ECP) on inflammatory factors in patients with acute coronary syndrome (ACS) after percutaneous coronary intervention (PCI).Methods The patients (n=118, male 68 and female 50) were chosen from Nov. 2012 to Aug. 2014, and divided randomly into group I (n=38), group II (n=40) and group III (n=40). All groups were given routine treatment (including aspirin, clopidogrel, statins, ACEI, ARB, β-receptor blockers, nitrates and low molecular weight heparin). Group I was given routine treatment only, group II was additionally given 0.9% sodium chloride injection (250 mL) or 5% glucose (250 mL) and Danhong Injection (40 mL), and group III was additionally given 0.9%sodium chloride injection (250 mL) or 5% glucose (250 mL) and Danhong Injection (40 mL) and ECP (1 h/time, 1 time/d) for 14 d. The levels of high-sensitivity C-reactive protein (hs-CRP), intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) were detected 1 d before PCI, 1 d after PCI (24 h± 2 h) and after PCI for 14 d.Results There were 2 patients in group I, 1 in group II and 3 in group III dropped out from the study because they cannot bear ECP or their disease exacerbated. The levels of hs-CRP, ICAM-1 and VCAM-1 increased in 3 groups 1 d after PCI compared with those 1 d before PCI (P<0.05). The levels of hs-CRP, ICAM-1 and VCAM-1 decreased in group II and group III compared with group I after treatment for 14 d (P<0.05), and decreased in group III compared with group II (P<0.05).Conclusion Danhong Injection combining ECP can reduce the levels of inflammatory factors in patients with ACS after PCI.