| Objective To observe and compare clinical effect and the blood level of hs-CRPand IL-2in patients with unstable angina, who were treated with the experimentaltreatment including conventional drugs, atorvastatin and tongxinluo capsule, and thecontrol group therapy of conventional drugs and atorvastatin. Discuss unstable angina’sshort-term clinical outcome and possible mechanism of action in the joint treatment ofatorvastatin and tongxinluo capsule.Methods This study was conducted between October2012and October2013.According to diagnostic criteria, inclusion criteria and exclusion criteria, the studyincluded59patients with unstable angina who were known to the department ofcardiology at yan’an university affiliated hospital, but according to TIMI riskstratification will not accept the early invasive revascularization of hospitalization, andthe patients were randomly divided into a control group which contained12femalepatients and17male patients, and a experimental group which contained12femalepatients and18male patients.Two groups of patients given conventional drugs(antiplatelet, anticoagulation, resistance to ischemic) and statins treatment(40mg ofatorvastatin and1times at night before sleeping), according to the Chinese medicalassociation cardiovascular epidemiology branch developed2007, the unstable angina andnon ST segment elevation myocardial infarction diagnosis and treatment guidelines.Then, the trial group plus tongxinluo capsules for3grains and3times per day on thebasis of the guidelines recommend. Both groups should be strictly control of risk factorsand given secondary prevention medication treatment. And then, measurer the bloodconcentration of hs-CRP and IL-2, respectively before treatment and after8weeks, theCarotid artery ultrasound examination at the beginning of treatment and after half an year in order to compare the carotid intima-media thickness. At the same time, record duringthe period of eight weeks for treating patients the frequency and degree of chest pain, STsegment and T wave recovery and adverse drug reactions, and the major adverse cardiacevents in half year. The relevant data collection and sorting, SPASS16.0applicationsoftware for statistical analysis.Results1.Hypersensitive c-reactive protein (hs-CRP): The control group andexperimental group the hs-CRP concentration of before and after treatment were tested:Control group,16.32±2.54mg/L and9.00±1.24mg/L, Experimental group:17.29±2.36mg/L and8.18±1.00mg/L. Compared the dates of control group and the experimentalgroup respectively, the results reveal a significantly statistical difference betweenthem(p＜0.01). The two groups comparison of hs-CRP concentration after treatmentshow the difference was statistically significant(p＜0.01).2.Interleukin2(IL-2): Compared the IL-2concentration of before and aftertreatment of control group and the experimental group respectively. IL-2levels werereduced, with a significantly statistical difference (Control group: from25.00±2.99to18.36±1.15, p＜0.01, Experimental group reduced from25.86±3.59to17.42±1.56, p＜0.01). Compared IL-2concentration after the test between two groups, the differencewas statistically significant (p＜0.05).3.Angina pectoris effect and ECG effect comparison: The total effectiveness ofangina after8weeks of treatment between control group and experimental grouprespectively are69.0%and93.4%, with a significantly statistical difference (p＜0.05).ECG total effective rate, respectively show68.9%and93.3%, with a significantlystatistical difference (p＜0.05).4.Carotid artery intima-media thickness (IMT): Control group and experimentalgroup before the treatment level of IMT is no statistical difference (p＞0.05), aftertreatment6months IMT have significantly decreased from1.39±0.09and1.27±0.78to2.25±0.21and2.24±0.22, p＜0.01, and the experimental group decreased moresignificantly than control group, the difference was statistically significant (p＜0.01). 5.Adverse drug reactions and the incidence of major adverse cardiac events withinsix months: During the period of strict observation of medication eight weeks, there are2cases patients have mild gastrointestinal reaction in experimental group, and two groupswere not found serious damage of liver and kidneys, rhabdomyolysis and othercomplications. Treatment in the first6months, the control group2cases appeared to beinvasive revascularization therapy, including1case of acute myocardial infarction, theother1case for patients with unstable angina is aggravating; Experimental group only1case of hospitalized patients with unstable angina and no vascular reconstructiontreatment; In the two groups did not have death, stroke and other adverse events occur.Conclusions1.Joint atorvastatin and tongxinluo capsule can better play to theanti-inflammatory immune response and resistance to atherosclerosis.2. Atorvastatin combined tongxinluo capsule can significantly relieve the symptomsof myocardial ischemia in patients with unstable angina.3.Atorvastatin combined tongxinluo capsule maybe could reduce the incidence ofadverse cardiovascular events in patients with unstable angina. |
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