炎症与不稳定型冠状动脉疾病的关系及治疗的研究

目的：探讨炎症介质与不稳定型冠状动脉疾病（UCAD）的关系及中西医结合序贯治疗的疗效。方法：大耳白兔高脂饲料喂7周建立动脉粥样硬化模型后，随机分3组，中西医结合序贯治疗组（A组），西医序贯治疗组（B）和常规治疗组（Ｃ组）。注射垂体后叶素后６h，A组依顺序给予阿斯匹林，硝酸异山梨酯、低分子肝素钙、降纤酶、参麦注射液及神农33注射液治疗；B 组除不用参麦注射液及神农33注射液，余同A组；C组除不同降纤酶，余同B组。观察给药前及其后的6h和72h血清白介素－6（IL－6），可溶性细胞间黏附分子－1（sICAM-1)和血浆纤维蛋白原变化及病理改变。结果：血清IL－6,sICAM-1，血浆纤维蛋白原在心肌缺血6h升高，在心肌缺血72h显著性升高，普通病理和电镜显示A组疗效最佳，B组次之，C组较差。A组和B组血浆纤维蛋白原水平较C组显著性改善。结论：IL－6， sICAM-1等炎性介质参与了UCAD的发生发展进程，提示UCAD的中西医结合序贯治疗明显优于常规治疗。

Study on the Relationship between Inflammation and Unstable Coronary Artery Disease and Treatment

To explore the relationship between inflammatory mediator and UCAD as well as the curative effect of the integrated traditional Chinese medicine and western medicine(TCM_WM)sequential therapy.Methods:Eighteen antherosclerotic big_ear rabbits were randomly divided into 3 groups after 6 hours of pituitrin injection.Aspirin,isosorbide dinitrate,and hepatin were administrated in group C.Defibrase was given besides the conventional in group B.Based on group B therapy,the others in group A were given shenmai injection and shennong 33 injection.Before and after 6 hours and 72 hours of pituierin injection,serum IL_6,sICAM_1,and plasma fibrinogens as well as pathological changes were respectively observed in each group.Results:Serum IL_6,sICAM_1,and plasma fibriogen increased in each group after 6 hours of putuitrin injection,and significantly increased after 72 hours.The plasma fibrinogens in group A and B were much improved.The therapeutic effect in group A was the best,and worst in group C proved by pathological changes.Conclusion:The inflammatory mediators such as IL_6 and sICAM_1 play a very important role in developing UCAD,TCM_WM sequential therapy can improve the curative effect.