| Objective:To observe the effect of Zhilong Huoxue Tongyu capsule on the serum markers of patients after PCI,such as NO,ET,CK-MB,c Tn I,hs-CRP,LVEF,etc,and to record the incidence of adverse cardiovascular events(MACE),and to explore the mechanism of Zhilong Huoxue Tongyu capsule on cardioprotective effect of patients after PCI.Methods :(1)Case selection:From November 2015 to April 2016,60 patients with coronary heart disease undergoing PCI operation were enrolled In the Southwest Medical University Affiliated Hospital of traditional Chinese Medicine Department of cardiovascular.Were randomly divided into control group and experimental group.There was no significant difference between the two groups in the basic data(age,sex,basic medication),past medical history(hypertension,diabetes,hyperlipidemia),medication condition(? receptor blockers,ARB,CCB,ACEI),risk factors(smoking,drinking)Differences are comparable.(2)Treatment programs:The two groups of patients after PCI were given conventional treatment of anticoagulation(low molecular weight heparin,5000 U,q12,use for 3 days),anti-platelet aggregation(aspirin 100 mg qd,clopidogrel sulfate 75 mg qd)and lipid(atorvastatin calcium tablets 20 mg qn or rosuvastatin 5 mg qn)etc.The experimental group in addition to Conventional treatment,plus leech dragon blood circulation Tongyu capsule(1.2 oral,tid).Treatment for 6 months.(3)Observation index:Respectively before operation,24 hours after operation and 72 hours after operation,The levels of c Tn I,CK-MB,hs-CRP were detected.Respectively before operation,24 hours after operation and 1 month after operation,The levels of NO,ET were detected.Respectively before and 3 months after PCI,The cardiac ultrasonography was examined,to observe left heart ejection fraction(LVEF);telephone follow-up was performed in June after operation to record adverse cardiovascular events.(4)Statistical software SPSS20.0 is used for statistical description and analysis of related data.Results :(1)hs-CRP:Before PCI,there was no significant difference in hs-CRP between the control group and the experimental group(P > 0.05).After PCI,the levels of hs-CRP in the two groups were increased,and hs-CRP decreased in the 72 hours after operation,compared with preoperative,the difference was statistically significant(P<0.05);compared with the contro group,The decrease of hs-CRP in the experimental group was more obvious,the difference was statistically significant(P <0.05);(2)CK-MB:Before PCI,there was no significant difference in CK-MB between the control group and the experimental group(P > 0.05).After PCI,the levels of CK-MB in the two groups were increased,and CK-MB decreased in the 72 hours after operation,compared with preoperative,the difference was statistically significant(P<0.01);compared with the contro group,The decrease of CK-MB in the experimental group was more obvious,the difference was statistically significant(P <0.001);(3)c Tn I:Before PCI,there was no significant difference in c Tn I between the control group and the experimental group(P > 0.05).After PCI,the levels of c Tn I in the two groups were increased,and c Tn I decreased in the 72 hours after operation,compared with preoperative,the difference was statistically significant(P<0.01);compared with the contro group,The decrease of c Tn I in the experimental group was more obvious,the difference was statistically significant(P <0.01);(4)NO:Before PCI,there was no significant difference in NO between the control group and the experimental group(P > 0.05).24 hours after PCI,The levels of NO in the two groups were decreased,compared with preoperative,the difference was statistically significant(P<0.001);the NO in the experimental group was slightly lower than that in the control group,but the difference was not statistically significant(P > 0.05);1 month after PCI,The levels of NO in the two groups were increased,compared with preoperative,the difference was statistically significant(P<0.001);compared with the contro group,The increase rate of NO in the experimental group was significantly higher than that in the control group,the difference was statistically significant(P <0.001);(5)ET:Before PCI,there was no significant difference in ET between the control group and the experimental group(P > 0.05).24 hours after PCI,The levels of ET in the two groups were increased,compared with preoperative,the difference was statistically significant(P<0.001);compared with the control group,the ET in the experimental group was slightly higher than that in the control group,but the difference was not statistically significant(P > 0.05);1month after PCI,The levels of ET in the two groups were decreased,compared with preoperative,the difference was statistically significant(P<0.001);compared with the control group,The decrease of ET in experimental group was significantly higher than that in control group,the difference was statistically significant(P<0.001);LVEF:Before PCI,there was no significant difference in LVEF between the control group and the experimental group(P > 0.05).3 months after PCI,The levels of LVEF in the control group increased slightly,but compared with the preoperative,the difference was not statistically significant(P > 0.05);The levels of LVEF in the experimental group increased significantly,and the preoperative and control group,the differences were statistically significant(P<0.05);(6)MACEs:6 months after PCI,the experimental group was lower than the control group in the adverse cardiovascular events and the total number of patients,but the discrepancy was not statistically meaning(P> 0.05).(8)Correlation between NO,ET and myocardial injury markers: 1 months after PCI,There was a negative correlation between ET and CK-MB and c Tn I(P<0.05).There was a positive correlation between ET and c Tn I(P <0.001).(9)Correlation between hs-CRP and myocardial injury markers: 24 hours after PCI,There was a positive correlation between hs-CRP and CK-MB and c Tn I(P<0.001).72 hours after PCI,There was a positive correlation between hs-CRP and c Tn I(P <0.05).Conclusion:(1)After PCI,coronary heart disease patients may have myocardial damage,inflammatory response and vascular endothelial function damage.The most obvious 24 hours after operation.Myocardial injury is closely related to vascular endothelial function and inflammatory reaction,the lighter the inflammation,the better the vascular endothelial function,the lighter the myocardial injury,and the heavier the contrary.(2)Zhilonghuoxue Tongyu capsule has a protective effect on cardiac function in patients with PCI after operation,reduce the adverse cardiovascular events.Curative effect is better than conventional western medicine treatment.(3)The mechanism of the protective effect of Zhilong Huoxue Tongyu capsules on cardiac may be related to the decrease of CK-MB,c Tn I,decrease ET,increase NO and inhibit inflammatory response. |
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