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Background: atherosclerotic coronary heart disease (coronary atherosclerotic heart disease, CAD) is a serious harm to human health, a common disease of life. The disease occurs after the age of 40, more men than women. Common in developed countries in Europe and the United States and the United States each year about 50 million people died of the disease, accounting for 1/3 to 1/2 of the deaths of the population, accounted for 50% to 75% of the number of deaths from heart disease. In our country, the disease is not as good as Europe and the United States more common, but in recent years its incidence and mortality showed an increasing trend, date to the 1990s, the mortality rate of the disease in China's urban males 49.2/10 million population, women 32.2 / 100,000. With the perfection of interventional cardiology technology, percutaneous coronary intervention treatment (percutaneous coronary intervention, PCI) as the main clinical treatment of this disease means made significant and certain clinical effect, but due to intraoperative balloon angioplasty and stent myocardial injury caused when implanted even microthrombi off triggered secondary distal occlusion of blood vessels gradually attracted attention. Range between 10% to 40% after PCI myocardial injury caused by the incidence of postoperative markers of myocardial necrosis is common in slightly increased. Heart-protecting musk pill by musk, ginseng extract, bezoar, and cinnamon, styrax, Toad and borneol, clinically past for the treatment of coronary heart disease, especially to relieve angina symptoms, has a rapid onset of efficacy, side effects, etc.. With a large number of basic research and clinical practice carried out in recent years, the role of the heart-protecting musk pill not only limited to the expansion of the coronary arteries, relieve angina symptoms, promote therapeutic angiogenesis, vascular protective effect, reduce infarct size, prevention of ventricular weight structure, regulate blood lipids, inhibit the vascular inflammatory response slowly. Myocardial damage after PCI, previous studies confirmed preoperative application atorvastatin statins trimetazidine Xuezhikang can significantly reduce the operations related to the incidence of myocardial injury, but about the large doses Shexiangbaoxin pill percutaneous coronary interventional treatment of perioperative myocardial protective effect has not been reported. Objective: To investigate the preoperative 3 d give large the dose Shexiangbaoxin pills (12 pills / day) for the treatment of patients with myocardial injury percutaneous coronary intervention: December 2008 to January 2010, Second Military Medical University, Changhai Hospital, Department of Cardiology, scheduled for coronary angiography, at the same time requires preoperative myocardial injury markers of myocardial troponin I cardiac troponin I (cTnI) and creatine kinase isoenzyme (creatine kinase-MB isoenzyme, CK-MB) negative more than 600 unstable angina (unstable angina, UA) patients were randomly divided into a control group and the test group. The control group received conventional treatment with placebo, conventional therapy including aspirin, clopidogrel, nitrates, statins and other test group on the basis of conventional therapy, in patients 3 d before the add services Shexiangbaoxin pill (4 pills / time, tid). The coronary angiography clear parallel percutaneous transluminal coronary angioplasty (percutaneous transluminal coronary angioplasty, PTCA) stenting lesions of the degree of stenosis in 70%. The two groups of a total of 133 patients were enrolled in the control group 67 cases, 66 cases of the experimental group. Subsequent detection of PCI 12,24 h after serum CK-MB, cTnI concentration. the cTnI assay applications ECLIA, United States Beckman Coulter's Access 2 automatic chemiluminescent immunoassay system and its radioimmunoassay kit; CK-MB enzyme activity inhibition assay detection applications, with Japan's Hitachi 7600-120 Biochemical Automatic Analyzer and the German Roche Diagnostics Ltd. creatine kinase isoenzyme kit detection. Follow-up 30 d after PCI cardiovascular events, including angina episodes, bleeding, stent restenosis, myocardial infarction, death, hospitalization for heart failure, stroke, and other circumstances. Results: The serum test group and a control group of patients before PCI cTnI, CK-MB level was no significant difference. 12,24 h after PCI cTnI levels of the experimental group was significantly lower than the control group (P lt; 0.01, P lt; 0.05); CK-MB levels compared to the control group of the trial group no significant difference (P gt; 0.05). Test group after PCI cTnI level more than three times ULN incidence was significantly lower than the control group, and that the incidence of CK-MB level more than 3 times the ULN test group and control group showed no significant difference (P lt; 0.05); statistically significant (P gt; 0.05). 30 d after each and total cardiovascular event rate in the test and control groups were not significantly different (P gt; 0.05). Conclusion: Preoperative 3 d give the large doses Shexiangbaoxin pill (12 pills / day) has a protective role for PCI perioperative myocardial injury, short-term prognosis of patients with unstable angina without significant improvement in role.
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