益气逐瘀法干预择期PCI围手术期对EPCs动员与归巢影响研究

摘要

目的:探讨益气逐瘀法对择期PCI围手术期EPCs动员与归巢影响.方法:采用随机、双盲、安慰剂、对照试验方法,研究对象为首都医科大学附属北京中医医院心血管科2016年7月至2016年11月成功接受PCI治疗的证属气虚血瘀证非ST段抬高急性冠脉综合征(NSTE-ACS)患者.64名符合纳入标准的患者被随机分为试验组(n=33)和对照组(n=31),对照组予常规西药治疗+安慰剂,试验组在常规西药治疗基础上加服参元丹胶囊,分别采用流式细胞仪、ELISA法进行检测2组择期PCI前后3个时点(术前、术后24 h、术后1周)外周血EPCs计数及促血管内皮生成因子VEGF水平,探索益气逐瘀法对NSTE-ACS患者择期PCI围手术期EPCs动员与归巢的影响.结果:2组受试者PCI术前外周血EPCs计数、VEGF水平比较差异无统计学意义(P=0.35、P=0.48),2组PCI术后外周血中EPCs计数及VEGF水平较术前均升高(P<0.05),但接受参元丹治疗的患者外周血中VEGF水平高于对照组.2组PCI术后7 d和术后24 h比较,外周血EPCs计数及VEGF水平均变化不大(P>0.05).结论:参元益气活血胶囊(参元丹)干预NSTE-ACS患者PCI围手术期可促进骨髓EPCs动员与归巢,其机制可能与SYD增加循环中VEGF水平有关.%Objective:To observe the effect of Qi-enhancing and Stagnation-removing therapy on EPCs mobilization and homing in PCI perioperative period.Methods:A randomized,double blind,placebo controlled trial was conducted.A total of 64 NSTE-ACS patients who received PCI and belongs to Qi-deficiency and blood-stasis syndrome were concluded in this study.Patients were randomized into Shen Yuan Dan(SYD) group (n=33) and the control group (n=31).The control group was given conventional western medicine treatment+placebo,on that basis,the treatment group was given SYD.Using flow cytometry instrument and ELISA method to detect EPCs count and VEGF levels of the two groups before and after elective PCI 3 points(preoperative and postoperative 24 hours,after 1 week).Results:Before treatment,the EPCs count and VEGF level were of no statistically significant difference between the two group (P=0.35,P=0.48).After treatment,the EPCs count in the peripheral blood and VEGF levels increased in both groups (P<0.05).While SYD group had higher VEGF than the control group.After treatment 7 d and 24 h,EPCs count and the level of VEGF in the peripheral blood of the two groups had no significant difference(P>0.05).Conclusion:Shen Yuan Dan in patients can promote bone marrow EPCs mobilization and homing in patients with NSTE-ACS PCI in perioperative period,it may be related to boosting VEGF levels.