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脑心通胶囊对临界病变冠心病患者炎症及预后的影响

[Effects of naoxintong capsule on the inflammation and prognosis in borderline lesion coronary heart disease patients].

作者信息

Li Shu-Ren, Wang Tian-Hong, Zhang Bao-Jun

机构信息

Department of Cardiology, Hebei Provincial People's Hospital, Shijiazhuang 050051.

出版信息

Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012 May;32(5):607-11.

Abstract

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 [interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha), and high sensitive C reaction protein (hs-CRP)], 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-alpha, hs-CRP, and MMP-9 between the two groups before treatment (P > 0.05). After 12 months of treatment, serum levels of IL-6, TNF-alpha, 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-alpha, 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 angina 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 disease patients. The post-treatment MMP-9 level and IL-6 level were independent risk factors influencing the recurrence of angina pectoris.

摘要

目的

研究脑心通胶囊(NC)对临界病变冠心病患者炎症及远期预后的影响。

方法

选取240例有胸痛症状且经冠状动脉造影或多层螺旋CT冠状动脉造影证实为临界病变冠心病(直径狭窄临界值为50% - 70%)的冠心病患者。将这些患者随机分为常规治疗组(包括使用硝酸盐、β受体阻滞剂、抗血小板、抗凝、血管紧张素转换酶抑制剂等)和NC治疗组(治疗方式同常规治疗组并加用NC)。所有患者均治疗12个月。观察治疗后心血管事件的发生情况。检测治疗前后血清中的炎症因子[白细胞介素6(IL - 6)、肿瘤坏死因子α(TNF - α)和高敏C反应蛋白(hs - CRP)]、基质金属蛋白酶 - 9(MMP - 9)、血脂和血糖、肝肾功能。

结果

治疗12个月后,NC治疗组心绞痛患者的发生率(6.67% 对15.83%,P < 0.05)和因急性冠状动脉综合征(ACS)发作而住院的发生率(4.17% 对10.83%)显著低于常规治疗组。治疗前两组血清IL - 6、TNF - α、hs - CRP和MMP - 9水平无统计学差异(P > 0.05)。治疗12个月后,两组血清IL - 6、TNF - α、hs - CRP和MMP - 9水平与治疗前相比均显著降低(P < 0.05)。此外,NC组血清IL - 6、TNF - α、hs - CRP和MMP - 9水平显著低于常规治疗组(P < 0.05)。通过Logistic回归分析发现,治疗后MMP - 9水平和IL - 6水平是影响心绞痛复发的独立危险因素。

结论

NC可减轻炎症。长期服用NC可降低临界病变冠心病患者心绞痛的复发率并降低ACS发作的发生率。治疗后MMP - 9水平和IL - 6水平是影响心绞痛复发的独立危险因素。

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