【摘要】 目的 探讨葛兰心宁软胶囊是否可通过抑制核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)炎症反应对PCI术后冠状动脉微血管疾病（CMVD）损伤起到保护作用。方法 对2021年7月至2022年9月期间因冠状动脉粥样硬化性心脏病（冠心病）成功行PCI，术后仍反复发作心绞痛等心肌缺血相关症状就诊于陕西省人民医院心血管内科，复查冠状动脉（冠脉）造影正常，通过SPECT测定冠脉血流储备（CFR）评价其冠脉微血管功能，将CFR<2.0诊断为冠脉微血管疾病的78例患者纳入研究，随机分为试验组（n=38）和对照组（n=40）。试验组给予葛兰心宁软胶囊联合常规西药治疗，对照组给予常规西药治疗。比较两组患者治疗前和治疗2个月后血浆NLRP3，白细胞介素-18(IL-18)水平和西雅图心绞痛问卷（SAQ）评分的变化。结果 治疗2个月后，2组患者NLRP3水平均低于治疗前，且试验组NLRP3水平显著低于对照组，差异具有统计学意义（P<0.01）。2组患者治疗后白细胞介素-1β(IL-1β)水平组间比较虽无统计学差异（P>0.05），但试验组IL-18水平较对照组下降更明显。治疗2个月后，两组患者SAQ评分均高于治疗前，且试验组高于对照组，差异具有统计学意义（P<0.05）。结论常规西药治疗与联合葛兰心宁软胶囊治疗均能降低NLRP3水平，并增加SAQ评分，但联合葛兰心宁治疗对NLRP3水平和SAQ评分的改善更大，推测葛兰心宁可能通过抑制NLRP3炎症反应改善CMVD。更多还原

【Abstract】 Objective To discuss whether Gelanxinning Soft Capsule may protect against injury of coronary microvascular disease(CMVD) through inhibiting NOD-like receptor thermal protein domain associated protein 3(NLRP3)inflammatory response or not after percutaneous coronary intervention(PCI). Methods The patients(n=78) received successful PCI due to coronary heart disease(CHD) were chosen from Department of Cardiovascular Medicine in People’s Hospital of Shaanxi Province from July 2021 to Sept. 2022. After the operation the patients suffered from repeated attack of angina pectoris(AP) and normal results of coronary angiography(CAG). The coronary microvascular function was reviewed through detecting coronary flow reserve(CFR) by using single photo emission computerized tomography(SPECT).The patients with CFR<2.0(n=78) were selected into the study, and they were randomly divided into test group(n=38) and control group(n=40). The test group was treated with Gelanxinning Soft Capsule and routine Western drugs and control group was treated with only routine Western drugs. The changes of levels of NLRP3 and interleukin-8(IL-18) and scores of Seattle Angina Questionnaire(SAQ) were compared between 2 groups before treatment and 2 months after treatment.Results After treatment for 2 months, NLRP3 level decreased in 2 groups, and NLRP3 was significantly lower in test group than that in control group(P<0.01). After treatment, the level of IL-18 had no statistical difference between 2 groups(P>0.05), but its decrease was more significant in test group compared with control group. After treatment for 2 months,SAQ scores were higher thanbefore treatment in 2 groups, and was higher in test group than that in control group(P<0.05).Conclusion Both routine Western therapy and Gelanxinning Soft Capsule can reduce NLRP3 level and promote SAQ scores, while Western therapy combined with Gelanxinning Soft Capsule has higher improving effect on NLRP3 level and SAQ scores. Gelanxinning Soft Capsule possibly ameliorates CMVD through inhibiting NLRP3 inflammatory response.更多还原