通心络对急性冠脉综合征介入治疗术患者内皮功能和高敏C反应蛋白的影响

目的：观察通心络对急性冠脉综合征经皮冠状动脉介入治疗术（percutaneous coronary intervention, PCI)患者内皮功能及高敏C反应蛋白（hypersensitive C-reactive protein, hs-CRP）的影响。方法：选择因冠脉狭窄病变而行PCI的冠心病不稳定型心绞痛患者33例，急性心肌梗死6例，随机分为常规治疗组（19例）和通心络组（20例）;通心络组为术后常规治疗基础上加用通心络4粒（每粒0.26 g），每日3次;测定术前，术后24 h，术后3个月一氧化氮合酶（NOS），一氧化氮（NO）以及hs-CRP的变化, 以肱动脉血流介导性扩张（flow-mediated diameter, FMD)评估血管内皮依赖性舒张功能, 并对NO和hs-CRP进行相关分析。结果：PCI术后24 h两组NOS，NO，FMD较术前明显减低（P＜0.05）, 两组hs-CRP均较术前增高（P＜0.05）; 术后3个月NOS，NO，FMD较术前明显增加（P＜0.05或P＜0.01），hs-CRP较术前明显减低（P＜0.01或P＜0.05），通心络组较常规治疗组上述变化更为显著（P＜0.05），NO和hs-CRP呈负相关（r=-0.3219, P＜0.01）。结论：通心络更能显著改善急性冠脉综合征PCI术患者的内皮功能，其机制可能为直接作用内皮细胞和抑制炎症反应。

Effect of Tongxinluo on endothelial function and hypersensitive C-reactive protein in acute coronary syndrome patients undergoing percutaneous coronary intervention

ObjectiveTo determine the effect of Tongxinluo on the endothelial function and hypersensitive C-reactive protein(hs-CRP) in acute coronary syndrome patients undergoing percutaneous coronary intervention(PCI).MethodsThirty-three patients with unstable angina pectoris and 6 patients with acute myocardial infarction who underwent PCI for stenotic lesions of the coronary artery were enrolled. The patients were randomly assigned to a conventional group(n=19) which took routine treatment or a tongxinluo group (n=20) which took Tongxinluo(4 capsules once, 3 times per day) at the base of routine treatment after PCI. Nitric oxide synthase (NOS), nitric oxide (NO), endothelium-dependent vasodilation which was evaluated in the brachial artery flow mediated diameter(FMD) and hs-CRP were measured before the PCI and 24 hours and 3 months after the PCI. The correlation between NO and hs-CRP was analyzed.ResultsNOS, NO, and FMD in the 2 groups 24 hours after the PCI were significantly lower than those before the PCI(P＜0.05), but hs- CRP obviously increased (P＜0.05). NOS, NO, and FMD 3 months after the PCI in the 2 groups were significantly higher than those before the PCI (P＜0.05 or P＜0.01), but hs-CRP obviously decreased (P＜0.01).All indexes mentioned above in the Tongxinluo group showed greater changes than those of the conventional group(P＜0.05). NO was negatively correlated with hs-CRP （r=-0.3219, P＜0.01）.ConclusionTongxinluo capsules have obvious beneficial effect on endothelial function and anti-inflammation in acute coronary syndrome patients undergoing PCI, by directly acting on the endothelium and indirectly inhibiting inflammation.