芪参益气滴丸联合阿托伐他汀对冠状动脉内支架再狭窄的干预

目的 探讨芪参益气滴丸联合阿托伐他汀对冠状动脉内支架再狭窄的干预作用.方法 纳入冠脉内支架置入术成功的141例冠心病患者,随机分为对照组（n=30）、芪参益气滴丸组（芪参组,n=36）、阿托伐他汀组（n=36）、和联合组（阿托伐他汀＋芪参益气滴丸,n=39）,药物治疗疗程均为6个月.采用冠状动脉定量分析支架术前、术后狭窄病变管腔内径和面积指标,评价阿托伐他汀、芪参益气滴丸及联合用药对支架内再狭窄的作用.结果 共有85例患者及108处支架在术后6个月内进行冠脉造影复查.四组患者随访时间及随访率比较,差异无统计学意义（P＞0.05）.芪参组、阿托伐他汀组、联合组支架内再狭窄率均低于对照组（P＜0.05）.联合组、阿托伐他汀组在晚期内径丢失、晚期内径丢失指数均小于对照组和芪参组（P＜0.05～0.01）;在支架置入血管段最小内径、净内径获得、净内径获得指数、管腔面积净获得方面均大于对照组和芪参组（P＜0.05～0.01）.联合组晚期内径丢失、晚期内径丢失指数、再狭窄率呈小于阿托伐他汀组趋势,而支架置入血管段最小内径、净内径获得、净内径获得指数、管腔面积净获得方面呈大于阿托伐他汀组趋势,但两组上述指标差异无统计学意义（P＞0.05）.结论 芪参益气滴丸联合阿托伐他汀对支架内再狭窄的防治有协同作用.

Intervention of Qishen Yiqi Diwan combining atorvastatin to coronary in-stent restenosis

Objective To investigate the intervention of Qishen Yiqi Diwan combining atorvastatin to coronary in-stent restenosis. Methods The patients (n=141) with coronary heart disease (CHD) after successful intracoronary stenting were randomly divided into control group (n=30),Qishen Yiqi Diwan group (n=36),atorvastatin group (n=36) and combining group (with Qishen Yiqi Diwan combining atorvastatin,n=39). A therapeutic course was 6 months. The indexes of luminal inner diameter and area of stenosis vessels were analyzed by using quantitative coronary analysis before and after stenting. The effects of atorvastatin,Qishen Yiqi Diwan and combination of them on in-stent restenosis were reviewed. Results There were totally 85 patients (108 stents) having reexamination of coronary angiography (CAG) withing 6 months after stenting. The differences in follow-up time and follow-up rate showed no statistical significant among four groups (P>0.05). The rate of in-stent restenosis was lower in Qishen Yiqi Diwan group,atorvastatin group and combining group than that in control group (P<0.05). The late loss and late loss index were less in combining group and atorvastatin group than those in control group and Qishen Yiqi Diwan group (P<0.05 to P<0.01). The minimum luminal diameter in stenting vessel segment,net inner getting,index of net inner getting and net area getting were all larger in combining group and atorvastatin group than those in control group and Qishen Yiqi Diwan group (P<0.05 to P<0.01). In combining group,the late loss,late loss index and restenosis rate trended to be less than those in atorvastatin group,and minimum luminal diameter in stenting vessel segment,net inner getting,index of net inner getting and net area getting trended to be larger than those in atorvastatin group,but there was no statistical significance between two groups (P>0.05). Conclusion Combination of atorvastatin and Qishen Yiqi Diwan has a synergistic effect in the prevention and treatment of in-stent restenosis.