摘要
目的研究双抗治疗联合桃红四物汤对稳定型冠心病经皮冠状动脉介入治疗(PCI)术后抗血小板的治疗效果及血清超敏C反应蛋白(hs-CRP)和P选择素水平的影响。方法选择稳定型冠心病PCI术后病人88例,随机分为对照组和试验组,各44例。对照组给予常规治疗(阿司匹林100 mg+氯吡格雷75 mg),试验组在对照组治疗的基础上加用桃红四物汤。两组治疗2周后采用Verifynow系统及流式细胞仪两种方法进行血小板功能检测,比较两组血小板抑制率及P选择素、hs-CRP等炎性指标。结果两组病人临床基线资料、实验室检查、冠状动脉造影及支架植入情况比较差异无统计学意义;以Verifynow系统中PRU≥208定义为血小板高反应性,对照组血小板高反应性有12例(27.3%),试验组有5例(11.4%);两组病人服药后PRU值差异有统计学意义,与对照组相比,试验组治疗后血小板抑制率明显升高(P<0.05);治疗2周后试验组P选择素与对照组比较差异有统计学意义,但两组hs-CRP比较差异无统计学意义;床旁快速血小板检测仪Verifynow系统的PRU值与经典实验室流式细胞仪检测的血小板反应指数(PRI)值存在显著相关性(r=0.337,P<0.01)。结论桃红四物汤联合常规双抗对稳定型冠心病PCI术后抗血小板治疗临床疗效确切,同时能一定程度上改善炎性反应,为临床抗血小板治疗提供新的思路。
Objective To study the therapeutic effect of dual anti-platelet therapy and Taohong Siwu decoction(TSD)on stable coronary heart disease(CHD)after percutaneous coronary intervention(PCI),and to investigate the effect on serum high-sensitivity C-reactive protein(hs-CRP)and P-selectin levels.Methods Eighty-eight patients with CHD after PCI were randomly divided into two groups:the control group(n=44)treated with routine treatment(aspirin 100 mg plus clopidogrel 75 mg),and the treatment group(n=44)treated with TSD in the basis of routine treatment for 2 weeks.After 2 weeks of treatment,Verifynow system and flow cytometry were used to detect the platelet function.The platelet inhibition rate,and the inflammatory indexes such as P-selectin and hs-CRP levels were measured simultaneously.Results There was no significant difference in clinical baseline data,laboratory examination,coronary angiography,and stent implantation between two groups.Platelet hyperreactivity was defined as P2Y12 reaction units(PRU)≥208 in the Verifynow system.Twelve patients(27.3%)had platelet hyperreactivity in the control group and 5(11.4%)in the treatment group.There was significant difference in the PRU values between two groups(P>0.05).Compared with the control group,the platelet inhibition rate was significantly increased in the treatment group after treatment(P<0.05).After 2 weeks of treatment,there was significant difference in P-selectin level between two groups,while there was no significant difference in hs-CRP level between two groups.There was a significant correlation between the PRU value of the Verifynow system at the bedside rapid platelet tester and the platelet reactivity index(PRI)value of the classic laboratory flow cytometer(r=0.337,P<0.01).Conclusion TSD and conventional dual anti-platelet therapy has a definite clinical effect on stable CHD after PCI.At the same time,it can improve the inflammatory response to a certain extent,and provide new ideas for clinical anti-platelet therapy.
作者
杨雅薇
周菁
姚磊
马丽萍
吴宗贵
符德玉
樊民
YANG Yawei;ZHOU Jing;YAO Lei;MA Liping;WU Zonggui;FU Deyu;FAN Min(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China)
出处
《中西医结合心脑血管病杂志》
2019年第23期3649-3653,共5页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
基金
上海市进一步加快中医药事业发展三年行动计划[No.ZY(2018-2020)-FWTX-8003]
岳阳医院院级课题(No.2019YYQ04)
