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1、参七汤干预冠心病支架植入术后再狭窄临床研究作者:赵华云,王文会,郎江明,陈伟强,罗子幸,余秀兰,贺青军【摘要】目的观察参七汤对冠心病支架植入术后炎症免疫反应、机体免疫状态以及再狭窄的影响,并探讨其作用机理。方法冠心病支架植入术后患者88例,采用随机、对照方法分为治疗组45例和对照组43例。对照组采用西医常规治疗,治疗组在其基础上加用参七汤,疗程6个月,观察再狭窄发生率、超敏C-反应蛋白(hsCRP)、活化的T淋巴细胞(CD3+/HLA-DR+)、可溶性白细胞介素-2受体(SIL-2R)及血瘀证、气虚证积分。结果治疗组再狭窄
2、率低于对照组(P<0.05)。冠状动脉介入术后,CD3+/HLA-DR+较术前降低,SIL-2R、hsCRP较术前升高,治疗组治疗后CD3+/HLA-DR+水平较对照组升高(P<0.01),SIL-2R、hsCRP水平较对照组降低(P<0.01),血瘀证积分和气虚证积分亦显著低于对照组(P<0.01),且持续到术后6个月。结论参七汤能有效减少冠心病冠状动脉介入术后再狭窄的发生。减少支架引起的炎症免疫反应,调节机体免疫状态,是其预防冠状动脉介入术后再狭窄的机制之一。【关键词】参七汤;冠心病;支架内再狭
3、窄;炎症免疫反应;T淋巴细胞活化26 Abstract:ObjectiveToobservetheeffectofShenqiDecoctiononinflammationandimmunereaction,immunestate,restenosis(RS)afterimplantationofstentsinpatientswithcoronaryarterydisease,andtoinvestigateitsmechanism.MethodsEighty-eightpatientswithcoronaryarte
4、rydiseaseafterimplantationofstentswererandomlydividedintothetreatmentgroup(45cases)andthecontrolgroup(43cases).Thecontrolgroupwastreatedwithroutinetreatment,andthetreatmentgroupwastreatedwithShenqiDecoctionadditionallyforsixmonths.RSrate,thelevelofhs-CRP,themarker
5、ofactivationofTlymphocytes(CD3+/HLA-DR+),sIL-2Randthescoresofblood-stasissyndromeanddeficiencyofQisyndromewereobserved.ResultsTheRSrateinthetreatmentgroupwaslowerthanthatinthecontrolgroup(P<0.05).AfterPCI,thelevelofCD3+/HLA-DR+waslowerwhilehs-CRPandsIL-2Rwashig
6、herthanbefore.AftertreatmentwithShenqiDecoction,thelevelofCD3+/HLA-DR+andhs-CRPwasobviouslyadvanced,andsIL-2Rwasobviouslydegradedthanthatofcontrolgroup(P<0.01).Thescoresofblood-stasissyndromeanddeficiencyofQisyndromeinthetreatmentgroupwassignificantlyloweredcom
7、paredwiththatinthecontrolgroup(P<0.01),andremainedto6months.ConclusionShenqiDecoctioncan26effectivelyreducetheoccurrenceofRSafterPCI.Reducingtheinflammationandimmunereactionofthestentsandregulatingtheimmunestateisoneofitsmechanisms. Keywords:ShenqiDecoction;co
8、ronaryarterydisease;in-stentrestenosis;inflammationandimmunereaction;Tlymphocytesactivation 经皮冠状动脉介入治疗(PercutaneousCoronaryIntervention,PCI)的成功开展和药物洗脱支