疏血通注射液对急性STEMI患者PCI术后冠脉微循环及血清ICAM-1、TNF-α、hs-CRP水平的影响

毛美娇; 赵英利; 邓兵; 邓博文; 郑望; 刘宇; 沈琳; 汤诺; 李广浩

doi:10.16306/j.1008-861x.2021.05.002

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疏血通注射液对急性STEMI患者PCI术后冠脉微循环及血清ICAM-1、TNF-α、hs-CRP水平的影响

临床研究 | 更新时间：2022-09-09

- 疏血通注射液对急性STEMI患者PCI术后冠脉微循环及血清ICAM-1、TNF-α、hs-CRP水平的影响
- Effects of Shuxuetong Injection on coronary microcirculation and serum ICAM-1, TNF-α and hs-CRP levels in patients with acute ST-segment elevation myocardial infarction after PCI
- 上海中医药大学学报 2021年35卷第5期页码：7-13
- 作者机构：
  
  1.上海中医药大学附属龙华医院心病科（上海　200032）
- 作者简介：
  
  毛美娇，女，在读博士生，主治医师，主要从事中医药防治心血管疾病临床研究
  邓兵，主任医师，硕士生导师；E-mail：dengbing82@sina.com
- 基金信息：
  
  上海市科委科研计划项目(16401971900);上海中医药大学附属龙华医院爱建捐赠基金资助项目(AJ025)
- DOI：10.16306/j.1008-861x.2021.05.002
  中图分类号：
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毛美娇, 赵英利, 邓兵, 等. 疏血通注射液对急性STEMI患者PCI术后冠脉微循环及血清ICAM-1、TNF-α、hs-CRP水平的影响[J]. 上海中医药大学学报, 2021,35(5):7-13.

MAO Meijiao, ZHAO Yingli, DENG Bing, et al. Effects of Shuxuetong Injection on coronary microcirculation and serum ICAM-1, TNF-α and hs-CRP levels in patients with acute ST-segment elevation myocardial infarction after PCI[J]. Academic Journal of Shanghai University of Traditional Chinese Medicine, 2021,35(5):7-13.
毛美娇, 赵英利, 邓兵, 等. 疏血通注射液对急性STEMI患者PCI术后冠脉微循环及血清ICAM-1、TNF-α、hs-CRP水平的影响[J]. 上海中医药大学学报, 2021,35(5):7-13. DOI： 10.16306/j.1008-861x.2021.05.002.

MAO Meijiao, ZHAO Yingli, DENG Bing, et al. Effects of Shuxuetong Injection on coronary microcirculation and serum ICAM-1, TNF-α and hs-CRP levels in patients with acute ST-segment elevation myocardial infarction after PCI[J]. Academic Journal of Shanghai University of Traditional Chinese Medicine, 2021,35(5):7-13. DOI： 10.16306/j.1008-861x.2021.05.002.

摘要

目的：,2,探讨疏血通注射液对急性ST段抬高型心肌梗死（STEMI）患者经皮冠状动脉介入（PCI）治疗后冠状动脉微循环及血清细胞间黏附分子-1（ICAM-1）、肿瘤坏死因子-α（TNF-α）、超敏C反应蛋白（hs-CRP）水平的影响。,方法：,2,纳入急性STEMI患者64例，随机分为对照组和疏血通组，每组各32例。所有患者均行PCI治疗，入院当日即开始药物干预，对照组患者给予西医常规治疗，疏血通组患者在西医常规治疗基础上加用疏血通注射液，连续用药7 d。于术前（治疗前）和术后7 d（治疗后）评价患者的中医证候积分，比较两组的中医证候疗效；术后30 min、2 h、24 h、7 d，评价并比较两组ST段完全回落患者的分布差异；治疗前和治疗后检测并比较两组患者的血清ICAM-1、TNF-α、hs-CRP水平。,结果：,2,研究过程中，对照组2例患者被剔除，最终疏血通组32例、对照组30例纳入统计分析。①治疗后，两组患者的中医证候主症、次症积分较治疗前均明显降低（,P,<,0.01），但组间积分比较差异无统计学意义（,P,>,0.05）；治疗后，疏血通组和对照组患者的中医证候疗效总有效率分别为93.75%和90.00%，疏血通组的疗效优于对照组（,P,<,0.05）。②术后7 d，疏血通组心电图ST段完全回落患者的占比较对照组明显增加（,P,<,0.05）。③治疗后，两组患者的ICAM-1水平较治疗前均升高（,P,<,0.05，,P,<,0.01），TNF-α、hs-CRP水平较治疗前均降低（,P,<,0.05，,P,<,0.01），且疏血通组患者的ICAM-1、TNF-α、hs-CRP水平均明显低于对照组（,P,<,0.05，,P,<,0.01）。,结论：,2,疏血通注射液结合西医常规疗法治疗STEMI患者PCI术后，可改善患者的临床症状及冠状动脉微循环障碍，减缓心肌梗死后黏附分子水平上升，降低炎症因子水平。

Abstract

Objective:,2,To investigate the effects of Shuxuetong Injection on coronary microcirculation and serum intercellular adhesion molecule-1(ICAM-1), tumor necrosis factor-α(TNF-α) and high sensitivity C reactive protein(hs-CRP) levels in patients with acute ST-segment elevation myocardial infarction(STEMI) after percutaneous coronary intervention(PCI) .,Methods:,2,A total of 64 patients with acute STEMI were included, and randomly divided into the control group and the Shuxuetong group, 32 cases in each group.All patients were treated with PCI, and the drug intervention was performed from the day of admission.The patients in the control group were treated with conventional western medicine, and the patients in the Shuxuetong group were treated with Shuxuetong Injection based on conventional western medicine, with a course of 7 days.Before operation(before treatment) and 7 days after operation(after treatment), the scores of Chinese medical syndrome were evaluated, and the efficacy of Chinese medical syndrome was compared between the two groups.Thirty minutes, 2 hours, 24 hours and 7 days after operation, the distribution difference of patients with complete ST-segment resolution(STR) in electrocardiogram was evaluated and compared between the two groups.Before and after treatment, the serum levels of ICAM-1, TNF-α and hs-CRP in the two groups were detected and compared.,Results:,2,During the study, two patients in the control group were eliminated.Finally 32 cases in the Shuxuetong group and 30 cases in the control group were included for the statistical analysis.①After treatment, the scores of the main and secondary symptoms of Chinese medical syndrome were significantly decreased in both groups compared with those before treatment(,P,<,0.01) .However, there were no statistically significant differences on the scores between the two groups(,P,>,0.05) .After treatment, the total effective rate of Chinese medical syndrome was 93.75% in the Shuxuetong group and 90.00% in the control group respectively, and the efficacy of the Shuxuetong group was better than that of the control group(,P,<,0.05) .②Seven days after operation, the proportion of patients with complete STR in electrocardiogram in the Shuxuetong group was significantly increased compared with that in the control group(,P,<,0.05) .③After treatment, the ICAM-1 level was increased in both groups compared with that before treatment(,P,<,0.05,P,<,0.01), and the levels of TNF-α and hs-CRP were decreased compared with those before treatment(,P,<,0.05,P,<,0.01) .The levels of ICAM-1, TNF-α and hs-CRP in the Shuxuetong group were significantly lower than those in the control group(,P,<,0.05,P,<,0.01) .,Conclusion:,2,Shuxuetong Injection combined with conventional western medicine can improve the clinical symptoms and the coronary microcirculation in treating patients with STEMI after PCI, slow down the increase of adhesion molecule level after myocardial infarction, and decrease the levels of inflammatory factors.

关键词

急性ST段抬高型心肌梗死PCI术后疏血通注射液冠脉微循环细胞间黏附因子-1

Keywords

acute ST-segment elevation myocardial infarctionPCI postoperationShuxuetong Injectioncoronary microcirculationintercellular adhesion factor-1

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