益气活血方对急性冠脉综合征患者PCI术后血小板功能、血管内皮功能和运动耐力的影响

目的探讨中药益气活血方对急性冠脉综合征(ACS)患者PCI术后血小板功能、血管内皮功能和运动耐力的影响。方法将2017年1月—2019年6月在沧州中西医结合医院心内科接受PCI治疗的120例ACS患者按照随机数字表法分为2组,每组60例,对照组术后予以西医常规治疗,治疗组在对照组治疗基础上应用中药益气活血方,2组疗程均为8周。观察2组治疗后第1秒用力呼气容积(FEV₁)、最大通气量(MVV)、左室舒张末期内径(LVEDD)、左室舒张末期容积(LVEDV)、左室射血分数(LVEF)、血小板功能指标(包括CD62p、CD63和Ⅱb/Ⅲa受体复合物)、血清血管生成素样蛋白2(Angptl2)、内皮素-1(ET-1)、一氧化氮(NO)水平及运动耐力无氧阈(AT)、最大摄氧量(VO₂max)、运动持续时间(ED)]。结果治疗后2组LVEDD、LVEDV、CD62p、CD63、Ⅱb/Ⅲa受体复合物、Angptl2、ET-1水平较治疗前明显降低(P均<0.05),LVEF、FEV₁、MVV、NO水平较治疗前明显升高(P均<0.05),治疗后治疗组各指标改善情况均优于对照组(P均<0.05)。治疗组治疗8周后VO₂max、AT、ED均明显高于对照组(P均<0.05)。结论在西医治疗基础上应用中药益气活血方有利于改善ACS患者PCI术后心肺功能、血小板功能和血管内皮功能,提高运动耐力。

Effect of Yiqi Huoxue Decoction on platelet function,vascular endothelial function and exercise endurance in patients with acute coronary syndrome after PCI

Objective It is to explore the effect of Yiqi Huoxue Decoction on platelet function,vascular endothelial function and exercise endurance in patients with acute coronary syndrome(ACS)after PCI.Methods 120 patients with ACS who received PCI in the Department of Cardiology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2017 to June 2019 were divided into 2 groups according to a random number table,60 cases in each group.The control group was treated with conventional western medicine after surgery,the treatment group was treated with Yiqi Huoxue Decoction on the basis of the treatment of the control group.The treatment course of the two groups was 8 weeks.The forced expiratory volume(FEV₁),maximum ventilation(MVV),left ventricular end diastolic diameter(LVEDD),left ventricular end diastolic volume(LVEDV),left ventricular ejection fraction(LVEF),levels of platelet functional indicators(including CD62p,CD63 andⅡb/Ⅲa receptor compound),serum angiopoietin-like protein 2(Angptl2),endothelin-1(ET-1),nitric oxide(NO)and exercise enduranceanaerobic threshold(AT),maximum oxygen uptake(VO₂max),exercise duration(ED)]after treatment were observed in the two groups.Results After treatment,LVEDD,LVEDV,and the levels of CD62p,CD63,Ⅱb/Ⅲa receptor compound,Angptl2 and ET-1 were significantly lower than those before treatment in the two groups(all P<0.05),and LVEF,FEV₁,MVV and the levels of NO were lower than those before treatment(all P<0.05),the improvement of each index in the treatment group after treatment was better than that of the control group(all P<0.05).After 8 weeks of treatment,VO₂max,AT and ED in the treatment group were significantly higher than those in the control group(all P<0.05).Conclusion The application of traditional Chinese medicine Yiqi Huoxue Decoction on the basis of western medicine treatment is beneficial to improve the cardiopulmonary function,platelet function and vascular endothelial function,and increase exercise endurance of ACS patients after PCI.