The Study Of On Blood-stasis Syndrome Of CM On The Patients Of ACS During The Perioperative Of PCI

ObjectiveTo explore the variation of Blood-stasis Syndrome on the patients of Acute Coronary Syndrome(ACS),investigate the effect of percutaneous coronary intervention(PCI) on the Blood stasis Syndrome.To explore the relation between Blood-stasis Syndrome and variety of factor,patient's general situation,regular blood test,interleukin-6(IL-6),interleukin-8(IL-8) and High Sensitive C-Reactive Protein(hs-CRP).To provide suggestions and informations to establish the measuring scale of Blood-stasis Syndrome on the patients of ACS.Methods122 patients of ACS,PCI treated,were selected in this study by coronary angiography.Classified the patients with Syndrome of CM,depending on the 'measuring scale for the dianosis of CM on CHD patients' edited by the Chinese Association of Integrated Medicine on 1990.According to the measuring scale for the diagnosis of Blood-stasis Syndrome given by 'Shiyong Xueyuzheng Xue'(1999),collected relative cases and then classified patients after scoring.Collected patients' blood serum before and after taking PCI and tested their levels of IL-6,IL-8 and hs-CRP.Analyzed the variation of patients' score and category on Blood-stasis Syndrome before and after the operation. Also analyzed the relationship between patients' general state of health, blood test indices,IL-6,IL-8,hs-CRP and the score on Blood-stasis Syndrome. To explore the influencing factors of IL-6,IL-8 and hs-CRP.ResultsThe most common syndromes of patients were blood-stasis,Qi deficiency and turbid phlegm.After taking PCI,the number of patients with blood-stasis and turbid phlegm syndromes reduced but more patients were reported with Qi deficiency syndrome.Patient's score on Blood-stasis Syndrome was higher before taking PCI.Over half of the patients who had heavy Blood-stasis Syndrome turn better to light Blood-stasis Syndrome after operation.It was higher preoperative score on blood-stasis syndrome with male patients than that of female patients,but the difference tended to disappear after operations.Patients with the history of revascularization had higher score on Blood-stasis Syndrome than others without such history.The average PTA of patients with lower preoperative score on Blood-stats Syndrome was higher than others but their APTT level was lower than patients with heavy Blood-Stasis Syndrome.In average,after taking PCI,patients over 60 years old had lower level of IL-6,IL-8 and hs-CRP than patients under their sixties.After operation, the levels of IL-8 and hs-CRP were higher than preoperative level.The level of hs-CRP was positively related with the number of stenotic coronary artery branch,WBC,neutrophils percentage,TG,LDH,ALP,Tn-I,D-diner,ESR and FIB and was negatively related with HDL and PTA.Patients with greasy diet had higher preoperative IL-8 level than patients with high sodium diet,ordinary diet and light diet.Patienswith greasy as well as high sodiumdiet had higher preoperative hs-CRP level than patients with greasy diet and ordinary diet. The preoperative IL-6 level of patients' were negatively related to D-diner, ESR and FIB.There was a negative relationship between IL-8 and patients' history of operation,neutrophi]s percentage and ESR.Classified by the condition of postoperative Blood-stasis Syndrome, patients with light syndrome had lower level of IL-6 and IL-8 than patients with heavy syndrome.The scoring on Blood-stasis Syndrome was positively related to preoperative IL-8 level no matter before or after the PCI;while, the postoperative IL-8 level was positively related to postoperative scoring on Blood-stasis Syndrome.Preoperative scoring on Blood-stasis Syndrome was negatively related to postoperative hs-CRP level.Setting preoperative scoring on Blood-stasis Syndrome as target,with the variables of gender,age, preoperative IL-6,preoperative IL-8 and preoperative hs-CRP,take a Logistic regression analysis,in which only the variable of gender was evolved.Setting postoperative scoring on Blood-stasis Syndrome as target,with the variables of gender,age,postoperative IL-6,postoperative IL-8 and postoperative hs-CRP,take a Logistic recession analysis,in which only the variable of postoperative IL-6 was evolved.Conclusions1.Due to the observed remission of Blood-stasis syndrome after PCI,it can be concluded that PCI was a kind of Blood-Activating therapy in Chinese traditional medicine.2.The most common syndromes of ACS were blood-stasis syndrome,Qi deficiency syndrome and turbid phlegm syndrome.After taking PCI,more patients were reported to had Qi deficiency syndrome while less cases with the other two syndromes.3.The gender of patients with ACS,the history of revascularization and coagulation makers may had influences on Blood-stasis Syndrome.4.There was certain relationship between IL-6,IL-8 and Blood-stasis syndrome on patients with ACS:when the indicators go up,the syndrome gets serious.5.IL-6,IL-8 and hs-CRP was related to patients' age and this relationship gets more obvious after PCI.Hs-CRP was related to WBC,cholesterol level and other factors.6.The standards of Blood-stasis Syndrome on ACS can be built on the basis of current scoring standards of Blood-stasis Syndrome.Former categories can be specified and evaluations on lab indicators should also be made.Some of the categories which were not directly related to ACS can be deleted; insteadly,add categories relative to this disease and change the weight of previous categories as well.It was recommended to delete some lab indicators which were not widely used and to replace them by new coagulation related indicators and other indicators based on Blood-stasis Syndrome research.