摘要
目的探讨通心络胶囊对冠状动脉旁路移植术后桥血管通畅情况的影响。方法将行冠状动脉旁路移植术的72例患者随机分为观察组35例和对照组37例。术后观察组在常规用药基础上服用通心络胶囊,对照组在常规用药基础上服用与通心络胶囊相同规格等量的安慰剂胶囊,治疗周期均为12个月。记录2组术前、术后1周、术后1个月、术后12个月左室射血分数(LVEF),检测2组术前、术后即刻、术后1个月、术后12个月血小板活化标志物和血管内皮功能指标,并于术后1周、1个月、12个月复查CT冠状动脉血管成像或冠脉造影了解桥血管通畅情况,统计2组术后12个月主要不良心血管事件(MACE)发生率。结果 2组术后12个月LVEF均明显高于术前(P均<0.05),且观察组明显高于对照组(P<0.05)。2组术后即刻α颗粒膜糖蛋白(CD62P)、血小板膜糖蛋白(GP)Ⅱb/Ⅲa受体复合物、内皮素-1(ET-1)水平均明显高于术前(P均<0.05),而术后1个月、术后12个月均明显低于术后即刻(P均<0.05),术后12个月明显低于术后1个月(P均<0.05);2组术后即刻一氧化氮(NO)水平均明显低于术前(P均<0.05),而术后1个月、术后12个月均明显高于术后即刻(P均<0.05),术后12个月明显高于术后1个月(P均<0.05);观察组术后1个月CD62P、GPⅡb/Ⅲa受体复合物水平和术后12个月ET-1水平均明显低于对照组(P均<0.05),术后12个月NO水平明显高于对照组(P<0.05)。2组术后1周、1个月、12个月左乳内动脉通畅率及术后1周、1个月大隐静脉通畅率比较差异均无统计学意义(P均>0.05),但观察组术后12个月大隐静脉通畅率明显高于对照组(P<0.05)。随访期间,观察组心力衰竭发生率明显低于对照组(P<0.05)。结论通心络胶囊可以提高冠状动脉旁路移植术后患者静脉桥血管通畅率,改善心功能。
Objective It is to investigate the effect of Tongxinluo capsule on the grafts of coronary artery bypass grafting（ CABG）. Methods 72 cases of successful implementation of CABG were randomly divided into observation group（ 35 cases） and control group（ 37 cases）. Conventional treatment was given to the observation group and control group. In addition,in the observation group,Tongxinluo capsules were given to the patients,while in the control group,the patients took placebo capsules（ with the same specification and dosage as those of Tongxinluo）,the treatment cycle was 12 months in both groups. Patients in the two groups were followed up for 12 months after surgery,and coronary angiography（ CAG） or coronary artery computed tomography was repeated. The left ventricular ejection fraction（ LVEF）,incidences of major adverse cardiovascular events（ MACE）,patency rate of grafts during follow-up and the related parameters including platelet activation markers and vascular endothelial function index during follow-up were compared between the two groups. Results In the patients of two groups LVEF were significantly increased after 12 months of the operation,the incidences of heart failure in observation group were significantly lower than that in the control group（ P〈0. 05）. In the patients of two groups on the date after the operation,the α granule membrane glycoprotein（ CD62 p）,platelet membrane glycoprotein（ GP） Ⅱb/Ⅲa receptor complexes and endothelin-1（ ET-1） were significantly increased,while nitric oxide（ NO） was decreased markedly compared with those before the operation in the same group. 1 months and 12 months after the operation in patients of two groups,CD62 p,GPⅡb/Ⅲa receptor complexes and ET-1 were decreased significantly,while NO was increased obviously compared with those in the same group on the date after the operation（ all P〈0. 05）; In the patients of two groups after 12 months of the operation,CD62 p,GPⅡb/Ⅲa receptor complexes and ET-1 were
作者
解鑫隆
徐朝军
项宇
倪广生
XIE Xinlong;XU Zhaojun;XIANG Yu;NI Guangsheng(The First Affiliated Hospital,Hunan University of Chinese Medicine,Changsha 410007,China;Hunan University of Chinese Medieine,Changsha 410208,China)
出处
《现代中西医结合杂志》
CAS
2018年第25期2737-2741,2753,共6页
Modern Journal of Integrated Traditional Chinese and Western Medicine
基金
湖南省中医药科研项目(201696)
中医内科学省部共建教育部重点实验室开放基金项目(ZYNK2015)
