通心络对急性冠脉综合征患者PCI术后炎性反应及血管内皮功能的影响

 目的 探讨通心络对急性冠脉综合征(acute coronary syndrome, ACS)患者PCI术后炎性反应及血管内皮功能的影响。方法 收集辽河油田总医院心内科2017-10至2018-03收治的拟行PCI治疗的ACS住院患者137例,以随机信封法分为通心络组(68例)和对照组(69例)。对照组给予冠心病常规治疗,通心络组在常规治疗的基础上给予通心络胶囊口服治疗,观察周期均为12周。监测两组PCI术后血管生成素样蛋白2(Angptl2)、白细胞介素(IL)-18及血浆纤溶酶原激活物抑制剂-1(PAI-1)水平变化,术后12周肱动脉血管内皮舒张功能(FMD)和小动脉弹性指数(C2)。结果 观察治疗12周后,两组Angptl2(27.61±8.55)ng/L,(32.30±11.56)ng/L]及IL-18(75.66±10.22)pg/ml,(91.81±12.99)pg/ml]水平均较治疗前(61.95±10.31)ng/L,(60.83±10.00)ng/L;(178.28±12.00)pg/ml,(180.12±10.43)pg/ml]显著降低(P＜0.05),同时PAI-1水平(26.64±8.0)μg/L,(30.92±6.64)μg/L]较治疗前(88.71±8.11) μg/L,(83.33±8.70) μg/L]显著降低(P＜0.05);且通心络组Angptl2及IL-18水平较对照组显著降低(P＜0.05);通心络组PAI-1水平低于对照组,两组间差异有统计学意义(P＜0.05)。治疗12周后两组FMD和C2均有改善,通心络组FMD(8.99±1.12),C2(6.32±0.70) ml/mmHg×100]水平明显优于对照组(6.65±0.95),(5.42±0.91)ml/mmHg×100]) (P＜0.05)。结论 通心络可通过降低Angptl2、IL-18、PAI-1水平及改善FMD和C2,减轻ACS患者PCI术后炎性反应、恢复血管内皮功能和修复小动脉弹性。

Effect of Tongxinluo on inflammation,endothelial function and artery elasticity in patients with acute coronary syndrome

Objective To study the effects of Tongxinluo on inflammation, endothelial function and artery elasticity in patients with acute coronary syndrome (ACS).Methods One hundred and thirty-seven patients who were diagnosed with ACS and prepared for PCI between October 2017 and March 2018 were selected as the subjects. They were randomly divided into the Tongxinluo group (n=68) and control group (n=69). Levels of Angptl2, IL-18, and PAI-1 in plasma were measured using ELISA methodology after admission and during the 12-week follow-up. The brachial artery flow-mediated dilation (FMD) and C2 were also calculated at the same time points and compared between the two groups.Results After 12-week follow-up, the levels of serum Angptl2, IL-18, and PAI-1 in the Tongxinluo group were (27.61±8.55) ng/L, (75.66±10.22) pg/mL and (26.64±8.00) μg/L respectively, which were lower than (32.30±11.56) ng/L, (91.81±12.99) pg/mL and (30.92±6.64) μg/L in the control group (P<0.05). Patients in the Tongxinluo group had higher levels of FMD (8.99±1.12) and C2 (6.32±0.70) ml/mmHg×100 than those (6.65±0.95;5.42±0.91) mL/mmHg×100] in the control group (P<0.05).Conclusions Tongxinluo capsules can reduce inflammation, restore the endothelial function and arterial elasticity in ACS patients.