目的:探讨丹红注射液用于冠心病介入治疗后血瘀证患者不良心血管事件(MACE)的影响及抗炎、血管内皮功能和抗血栓形成作用机制。方法:将170例经皮冠状动脉介入治疗(PCI)后冠心病患者,采用区组随机按数字表法分为对照组和观察组各85例。对照组口服拜阿司匹林肠溶片,100 mg/次,1次/d;硫酸氢氧吡格雷片,75 mg/次,1次/d;阿托伐他汀钙片,20 mg/次,1次/d;美托洛尔缓释片,200 mg/次,2次/d;硝酸异山梨酯,5~10 mg/次,2次/d;观察组术后西医治疗措施同对照组,并于PCI术后给予丹红注射液,40 m L溶于5%葡萄糖250 m L,静脉滴注,2次/d;两组治疗14 d为一个疗程。记录两组近期(6个月内)MACE发生情况,测量治疗前后血清内皮素(ET),一氧化氮(NO),同型半胱氨酸(HCY),血管性假血友病因子(v WF)和肱动脉介导内皮依赖性舒张功能(FMD)等血管内皮功能指标;检测治疗前后超敏C反应蛋白(hs-CRP),肿瘤坏死因子(TNF)-α,白细胞介素-6(IL-6)和细胞间黏附分子-1(ICAM-1)等炎症因子水平;检测治疗前后纤维蛋白原(FIB),D-二聚体(D-D),血小板活化程度(血小板膜糖蛋白CD63,CD62 p和GPⅡb/Ⅲa受体复合物表达水平)和血液流变学,记录治疗前后6 min步行试验(6 MWT)和血瘀证评分及西雅图心绞痛量表(SAQ)评分。结果:观察组近期(6个月随访期)MACE的累积发生率为21.52%,低于对照组的37.46%(χ2=5.371,P<0.05);治疗后观察组患者ET-1,v WF和Hcy水平均低于对照组,NO水平和FMD均高于对照组(P<0.01);治疗后观察组患者血清hs-CRP,TNF-α,IL-6和ICAM-1水平均低于对照组(P<0.01);观察组全血黏度(低切、高切)、血浆黏度和全血还原黏度等血液流变学指标改善均优于对照组(P<0.01);观察组患者血清FIB,D-D,CD63,CD62 p和GPⅡb/Ⅲa水平均低于对照组(P<0.01);观察组患者6 MWT多于对照组,血瘀证评分低于对照组,SAQ评分高于对照组(P<0.01)。结论:丹红注射液的使用能改善冠心病PCI术后患者的血管内皮功能,具有抗炎、改善血管内皮功能和抗血栓形的作用,减少了MACE的累积发生率,且改善了临床症状,提高了生活质量。 Objective: To investigate the effect of Danhong injection on adverse cardiovascular events (MACE) and anti-inflammatory, endothelial function and antithrombotic mechanism in patients with blood stasis syndrome after coronary intervention. Methods: One hundred and seventy-five patients with coronary heart disease after percutaneous coronary intervention (PCI) were randomly divided into control group and observation group with 85 cases in each group. Control group oral aspirin enteric-coated tablets, 100 mg / time, 1 / d; OxyClin hydrochloride tablets, 75 mg / time, 1 / d; atorvastatin calcium tablets, 20 mg / time, 1 / d; metoprolol sustained release tablets, 200 mg / time, 2 times / d; isosorbide mononitrate, 5 ~ 10 mg / time, 2 times / d; Western medicine treatment group after treatment with the control group and Danhong injection was given after PCI, 40 ml dissolved in 250 ml of 5% dextrose, intravenous drip, twice a day; the two groups were treated for 14 days for one course of treatment. The incidence of MACE was recorded in both groups (within 6 months) before and after treatment. The changes of serum endothelin (ET), nitric oxide (NO), homocysteine ​​(HCY), vWF ) And brachial artery-mediated endothelium-dependent vasodilation (FMD) were measured before and after treatment. The levels of hs-CRP, TNF-α and IL- -6), ICAM-1 and other inflammatory cytokines were measured before and after treatment. The levels of fibrinogen (FIB), D-dimer (DD), platelet activation (platelet membrane glycoprotein CD63, CD62 p and GPⅡb / Ⅲa receptor complex levels) and hemorrheology. Six-minute walking test (6 MWT), blood stasis syndrome score and Seattle angina pectoris scale (SAQ) score were recorded before and after treatment. Results: The cumulative incidence of MACE was 21.52% in the observation group (6 months follow-up), which was lower than 37.46% in the control group (χ2 = 5.371, P <0.05) Hcy levels were lower than the control group, NO levels and FMD were higher than the control group (P <0.01); after treatment, the levels of serum hs-CRP, TNF-α, IL-6 and ICAM-1 in the observation group were lower than those in the control group (P <0.01). The improvement of hemorrheological indexes such as whole blood viscosity (low-cut, high-cut), plasma viscosity and whole blood reduced viscosity in the observation group were better than those in the control group The levels of DD, CD63, CD62p and GPⅡb / Ⅲa in the observation group were significantly lower than those in the control group (P <0.01). The 6 MWT in the observation group was more than that in the control group, the blood stasis syndrome score was lower than that in the control group, 0.01). Conclusion: The use of Danhong injection can improve the vascular endothelial function in patients with coronary artery disease after PCI. It has the effects of anti-inflammation, improving endothelial function and anti-thrombosis, reducing the cumulative incidence of MACE and improving clinical symptoms, Improve the quality of life