Objective：To determine the impact of adjunctive Buchang Naoxintong Capsule（步心脑心通胶囊,NXT） on dual antiplatelet therapy in patients with cytochrome P450 2C19＊2（CYP2C19＊2） polymorphism undergoing percutaneou...Objective：To determine the impact of adjunctive Buchang Naoxintong Capsule（步心脑心通胶囊,NXT） on dual antiplatelet therapy in patients with cytochrome P450 2C19＊2（CYP2C19＊2） polymorphism undergoing percutaneous coronary intervention（PCI）.Methods：Ninety patients with CYP2C19＊2 polymorphism were enrolled,and their genotypes were confirmed by polymerase chain reaction（PCR）.The patients were randomly assigned to receive either adjunctive NXT（triple group,45 cases） or dual antiplatelet therapy（dual group,45 cases） using a computer-generated randomization sequence and sealed envelopes.Platelet function was assessed at baseline and 7 days after treatment with conventional aggregometry.Subsequent major adverse cardiovascular events（MACE,including sudden cardiac arrest and acute coronary syndrome） were recorded during a 12-month followup.Results：Baseline platelet function measurements were similar in both groups.After 7 days,percent inhibitions of maximum platelet aggregation and late platelet aggregation were significantly greater in the triple versus dual group（42.3%±16.0%vs.20.8%±15.2%,P〈0.01,and 54.7%±18.3%vs.21.5%±29.2%,P〈0.01,respectively）.During the 12-month follow-up,the rate of subsequent MACE（6/45） was significantly lower in the triple group compared with the dual group（14/45;P〈0.05）.Conclusion：Adjunctive NXT to maintenance dose clopidogrel（75 g） could enhance the antiplatelet effect and decrease subsequent MACE in patients with the CYP2C19＇2polymorphism undergoing PCI.展开更多
目的：采用Meta分析对步长脑心通胶囊治疗短暂性缺血性脑发作临床疗效和安全性进行评价。方法：计算机检索Pub Med、CENTRAL、EMbase、the ISI Web of Knowledge Databases、VIP、CNKI、CBM和Wangfangdate,查找所有步长脑心通胶囊治疗...目的：采用Meta分析对步长脑心通胶囊治疗短暂性缺血性脑发作临床疗效和安全性进行评价。方法：计算机检索Pub Med、CENTRAL、EMbase、the ISI Web of Knowledge Databases、VIP、CNKI、CBM和Wangfangdate,查找所有步长脑心通胶囊治疗短暂性缺血性脑发作的随机对照试验（RCT）,检索时限均为建库至2015年4月31日。同时手检纳入文献的参考文献。按纳入排除标准由两人独立进行RCT的筛选、资料提取和质量评价后,采用Rev Man 5.1软件进行Meta分析。结果：共纳入18个RCT研究,2213例患者,疗效系统评价：①临床疗效改变12个试验的meta分析结果显示：脑心通组临床疗效改善明显优于对照组[M-H=5.70,95%CI（3.91,8.33）P〈0.00001];②血液流变学改变6-8个试验的meta分析结果显示：脑心通组改善血液流变学特征（全血高切粘度、全血低切粘度、血浆黏度）明显优于对照组[WMD=-1.08,95%CI（-1.57,-0.59）P〈0.0001]、[WMD=-1.17,95%CI（-1.93,-0.41）P=0.01]、[WMD=-0.27,95%CI（-0.46,-0.09）P=0.004]。2抗凝血改变2个试验的meta分析结果显示：脑心通组减低血小板粘附率、抑制血小板凝聚明显优于对照组[WMD=-5.93,95%CI（-8.01,-3.85）P〈0.00001。抗凝血作用中,5个试验的meta分析结果显示脑心通组减低纤维蛋白原明显优于对照组[WMD=-1.02,95%CI（-1.40,-0.64）P〈0.00001]。2个试验的meta分析结果显示：脑心通组减低血浆D-二聚体明显优于对照组[WMD=-0.03,95%CI（-0.06,-0.00）P=0.04]。③脑血流动力学变化2个试验的meta分析结果显示：脑心通组治疗2周后左椎动脉LVA平均峰流速度、右椎动脉RVA平均峰流速度、基底动脉BA平均峰流速度与对照组相比无显著性差异[WMD=2.83,95%CI（-1.31,6.97）P=0.18]、[WMD=2.64,95%CI（-2.59,7.86）P=0.32]、[WMD=5.46,95%CI（-2.72,13.63）P=0.19]。结论：步长脑心通胶囊治疗治疗短暂性缺血性脑发作可抑制血小板凝聚,抗凝血,改善血液流�展开更多
基金Supported by the Provincial Natural Science Foundation of Fujian(No.2011J0133)the National Natural Science Foundation of China(No.81373838)
文摘Objective：To determine the impact of adjunctive Buchang Naoxintong Capsule（步心脑心通胶囊,NXT） on dual antiplatelet therapy in patients with cytochrome P450 2C19＊2（CYP2C19＊2） polymorphism undergoing percutaneous coronary intervention（PCI）.Methods：Ninety patients with CYP2C19＊2 polymorphism were enrolled,and their genotypes were confirmed by polymerase chain reaction（PCR）.The patients were randomly assigned to receive either adjunctive NXT（triple group,45 cases） or dual antiplatelet therapy（dual group,45 cases） using a computer-generated randomization sequence and sealed envelopes.Platelet function was assessed at baseline and 7 days after treatment with conventional aggregometry.Subsequent major adverse cardiovascular events（MACE,including sudden cardiac arrest and acute coronary syndrome） were recorded during a 12-month followup.Results：Baseline platelet function measurements were similar in both groups.After 7 days,percent inhibitions of maximum platelet aggregation and late platelet aggregation were significantly greater in the triple versus dual group（42.3%±16.0%vs.20.8%±15.2%,P〈0.01,and 54.7%±18.3%vs.21.5%±29.2%,P〈0.01,respectively）.During the 12-month follow-up,the rate of subsequent MACE（6/45） was significantly lower in the triple group compared with the dual group（14/45;P〈0.05）.Conclusion：Adjunctive NXT to maintenance dose clopidogrel（75 g） could enhance the antiplatelet effect and decrease subsequent MACE in patients with the CYP2C19＇2polymorphism undergoing PCI.
文摘目的：采用Meta分析对步长脑心通胶囊治疗短暂性缺血性脑发作临床疗效和安全性进行评价。方法：计算机检索Pub Med、CENTRAL、EMbase、the ISI Web of Knowledge Databases、VIP、CNKI、CBM和Wangfangdate,查找所有步长脑心通胶囊治疗短暂性缺血性脑发作的随机对照试验（RCT）,检索时限均为建库至2015年4月31日。同时手检纳入文献的参考文献。按纳入排除标准由两人独立进行RCT的筛选、资料提取和质量评价后,采用Rev Man 5.1软件进行Meta分析。结果：共纳入18个RCT研究,2213例患者,疗效系统评价：①临床疗效改变12个试验的meta分析结果显示：脑心通组临床疗效改善明显优于对照组[M-H=5.70,95%CI（3.91,8.33）P〈0.00001];②血液流变学改变6-8个试验的meta分析结果显示：脑心通组改善血液流变学特征（全血高切粘度、全血低切粘度、血浆黏度）明显优于对照组[WMD=-1.08,95%CI（-1.57,-0.59）P〈0.0001]、[WMD=-1.17,95%CI（-1.93,-0.41）P=0.01]、[WMD=-0.27,95%CI（-0.46,-0.09）P=0.004]。2抗凝血改变2个试验的meta分析结果显示：脑心通组减低血小板粘附率、抑制血小板凝聚明显优于对照组[WMD=-5.93,95%CI（-8.01,-3.85）P〈0.00001。抗凝血作用中,5个试验的meta分析结果显示脑心通组减低纤维蛋白原明显优于对照组[WMD=-1.02,95%CI（-1.40,-0.64）P〈0.00001]。2个试验的meta分析结果显示：脑心通组减低血浆D-二聚体明显优于对照组[WMD=-0.03,95%CI（-0.06,-0.00）P=0.04]。③脑血流动力学变化2个试验的meta分析结果显示：脑心通组治疗2周后左椎动脉LVA平均峰流速度、右椎动脉RVA平均峰流速度、基底动脉BA平均峰流速度与对照组相比无显著性差异[WMD=2.83,95%CI（-1.31,6.97）P=0.18]、[WMD=2.64,95%CI（-2.59,7.86）P=0.32]、[WMD=5.46,95%CI（-2.72,13.63）P=0.19]。结论：步长脑心通胶囊治疗治疗短暂性缺血性脑发作可抑制血小板凝聚,抗凝血,改善血液流�
