He Gui-Xin, Xie Jun, Jiang Hao, Tan Wei, Xu Biao
Department of Cardiology, Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, China.
Department of Cardiology, the First Affiliated Hospital of Guangxi University of Chinese Medicine, Nanning, 530023, China.
Chin J Integr Med. 2018 Mar;24(3):193-199. doi: 10.1007/s11655-017-2955-1. Epub 2017 May 3.
To evaluate the effect of treatment with Qishen Yiqi Dripping Pills (, QSYQ) on myocardial injury and myocardial microvascular function in patients undergoing elective percutaneous coronary intervention (PCI).
Eighty patients undergoing elective PCI were randomly assigned to QSYQ and control groups. The QSYQ group received QSYQ at a dosage of 0.5 g 3 times daily (3-7 days before PCI and then daily for 1 month) and regular medication, which comprised of aspirin, clopidogrel, statin, β-blocker, and angiotensin-converting enzyme inhibitor/angiotensin receptor blocker in the absence of contradiction. The control group received only the regular medication. The index of microcirculatory resistance (IMR) was measured at maximal hyperemia after PCI. The fractional flow reserve was measured before and after the procedure. Troponin I levels were obtained at baseline and 20-24 h after the procedure.
Pre-PCI troponin I levels between the two groups were similar (0.028±0.05 vs. 0.022±0.04 ng/mL, P=0.55). However, post- PCI troponin I levels in the QSYQ group were significantly lower than that in the control group (0.11±0.02 vs. 0.16±0.09 ng/mL, P<0.01). IMR values were significantly lower in the QSYQ group as compared to the control group (16.5±6.1 vs. 31.2±16.0, P<0.01). Multivariate analysis identified QSYQ treatment as the only independent protective factor against IMR >32 (odds ratio=0.29, 95% confidence interval: 0.11-0.74, P=0.01).
The present study demonstrated the benefit of QSYQ in reducing myocardial injury and preserving microvascular function during elective PCI.
评估芪参益气滴丸（QSYQ）对择期经皮冠状动脉介入治疗（PCI）患者心肌损伤及心肌微血管功能的影响。
80例择期PCI患者随机分为QSYQ组和对照组。QSYQ组在PCI术前3 - 7天开始服用芪参益气滴丸，剂量为0.5 g，每日3次，术后持续服用1个月，并服用常规药物，包括阿司匹林、氯吡格雷、他汀类药物、β受体阻滞剂以及无禁忌证时使用的血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂。对照组仅服用常规药物。PCI术后在最大充血状态下测量微循环阻力指数（IMR）。在手术前后测量血流储备分数。在基线及术后20 - 24小时检测肌钙蛋白I水平。
两组PCI术前肌钙蛋白I水平相似（0.028±0.05 vs. 0.022±0.04 ng/mL，P = 0.55）。然而，QSYQ组PCI术后肌钙蛋白I水平显著低于对照组（0.11±0.02 vs. 0.16±0.09 ng/mL，P < 0.01）。与对照组相比，QSYQ组的IMR值显著更低（16.5±6.1 vs. 31.2±16.0，P < 0.01）。多因素分析确定QSYQ治疗是唯一针对IMR > 32的独立保护因素（比值比 = 0.29，95%置信区间：0.11 - 0.74，P = 0.01）。
本研究表明芪参益气滴丸在择期PCI期间对减轻心肌损伤和保护微血管功能有益。
