2024 年第 6 期 第 0 卷

葛兰心宁软胶囊联合常规西药治疗经皮冠状动脉介入术后冠状动脉微血管疾病的临床效果及对血浆相关因子水平的影响

Clinical effect of Gelanxinning soft capsules combined with conventional western medicine on coronary microvascular disease after percutaneous coronary intervention and its influence on levels of plasma related factors

作者：蒋红英1王依阳1赵慧1梁宸源1姜瑞嘉1任园园1陈亮1杨达2胡小虎2许百灵3 方纬4程功1

英文作者：Jiang Hongying1 Wang Yiyang1 Zhao Hui1 Liang Chenyuan1 Jiang Ruijia1 Ren Yuanyuan1 Chen Liang1， Yang Da2 Hu Xiaohu2 Xu Bailing3 Fang Wei4 Cheng Gong1

单位：1陕西省人民医院心血管内科，西安710068；2西安千禾药业股份有限公司，西安710075；3美国密苏里哥伦比亚大学-核科学暨工程研究所，密苏里州MO65211；4中国医学科学院阜外医院核医学科，北京100037

英文单位：1Department of Cardiology Shaanxi Provincial People′s Hospital Xi′an 710068 China; 2Xi′an Chiho Pharmaceutical Co. Ltd. Xi′an 710075 China; 3Columbia University of Missouri-Institute of Nuclear Science and Engineering Missouri MO 65211 USA; 4Department of Nuclear Medicine Fuwai Hospital China Academy of Medical Sciences Beijing 100037 China

关键词：冠状动脉微血管疾病；葛兰心宁软胶囊；可溶性尿激酶型纤溶酶原激活剂受体；可溶性生长刺激表达基因2蛋白

英文关键词：Coronarymicrovasculardisease;Gelanxinningsoftcapsules;Solubleurokinaseplasminogenactivatorreceptor;Solublegrowthstimulationexpressedgene2protein

• 摘要：

• 目的 观察葛兰心宁软胶囊联合常规西药治疗经皮冠状动脉介入（PCI）术后冠状动脉微血管疾病（CMVD）的临床效果及对血浆可溶性尿激酶型纤溶酶原激活剂受体（suPAR）和可溶性生长刺激表达基因2蛋白（sST2）水平的影响。方法 选取2021年7月至2022年9月于陕西省人民医院行PCI术后发生CMVD的78例患者纳入研究。完全随机分为观察组（38例）和对照组（40例）。对照组给予常规西药治疗，观察组在对照组的基础上给予葛兰心宁软胶囊口服治疗，2组均连续治疗2个月。比较2组一般资料和临床疗效及治疗前后血浆suPAR和sST2水平变化。结果 2组性别、年龄、体重指数、既往史、服药史及常规生化指标水平比较差异均无统计学意义（均P>0.05）。观察组总有效率高于对照组［89.5%（34/38）比25.0%（10/40）］，差异有统计学意义（P＜0.001）。2组各不良反应发生率差异均无统计学意义（均P＞0.05）。治疗后，2组suPAR水平均低于治疗前（均P<0.05），sST2水平与治疗前比较差异均无统计学意义（均P>0.05），但sST2在观察组表现出下降的趋势，同时观察组suPAR、sST2水平均低于对照组［（4.4±2.5）μg/L比（5.6±2.6)μg/L、6.12（4.51，10.35）μg/L比9.92（6.33，15.51）μg/L］，差异均有统计学意义（均P<0.05）。结论 葛兰心宁软胶囊联合常规西药治疗不仅可以改善PCI术后CMVD患者的心绞痛症状，还可以下调血浆suPAR和sST2水平，且安全性好。推测以上2个因子的下调可能与葛兰心宁软胶囊对CMVD损伤的防护作用有关。

• Objective To observe the clinical effect of Gelanxinning soft capsule combined with conventional western medicine on coronary microvascular disease(CMVD) after percutaneous coronary intervention(PCI) and its influence on levels of plasma soluble urokinase plasminogen activator receptor(suPAR) and soluble growth stimulation expressed gene 2 protein(sST2). Methods Totally 78 patients with postoperative CMVD after PCI at Shaanxi Provincial People′s Hospital from July 2021 to September 2022 were selected for the study. Patients were completely randomized into observation group(38 cases) and control group(40 cases). The control group was given conventional western medicine treatment, while the observation group was given Gelanxinning soft capsules orally on the basis of the control group. Both groups were treated continuously for 2 months. The general information, clinical efficacy, and changes in plasma suPAR and sST2 levels before and after treatment were compared between the two groups. Results There were no statistically significant differences in gender, age, body mass index, past medical history, medication history, and routine biochemical indicators between the two groups (all P>0.05). The total effective rate of the observation group was higher than that of the control group［89.5%(34/38) vs 25.0%(10/40)］(P<0.001). There was no statistically significant difference in the incidence of adverse reactions between the two groups(all P>0.05). After treatment, the levels of suPAR in both groups were lower than those before treatment(all P<0.05). There was no statistically significant difference in the levels of sST2 before and after treatment in the two groups(all P>0.05), but sST2 showed a decreasing trend in the observation group. The levels of suPAR and sST2 in the observation group after treatment were lower than those in the control group［(4.4±2.5)μg/L vs (5.6±2.6)μg/L, 6.12(4.51,10.35)μg/L vs 9.92(6.33,15.51)μg/L］(both P<0.05). Conclusions  Gelanxinning soft capsules combined with conventional western medicine treatment can not only improve angina pectoris symptoms in patients with CMVD after PCI, but also down-regulate the plasma levels of suPAR and sST2, with good safety. It is speculated that the down-regulation of the above two factors may be related to the protective effect of Gelanxinning soft capsules on the damage of CMVD.