【作者】 孟晓；

【导师】 黎莉；

【作者基本信息】 山东大学 ， 内科学， 2007， 硕士

【摘要】 背景心脑血管疾病是严重危害人类健康的常见病和多发病，已成为当今人类死亡的首位原因，而动脉粥样硬化是这些疾病的主要病理基础。动脉粥样硬化是一种全身性血管疾病，一般最常见于冠状动脉、颈动脉等全身大中动脉血管。近年的研究已表明，颈动脉和冠状动脉病变具有相同的致病因素，颈动脉粥样硬化与冠状动脉硬化之间存在着紧密的联系，二者的病变是平行的。既往的研究表明，动脉粥样硬化是一个进行性的线性发展过程，由于脂质沉积动脉内膜下形成斑块，斑块逐渐增大凸入管腔，造成管腔的狭窄和组织缺血，最终导致急性心血管事件的发生。心肌梗死的发生主要是在冠状动脉粥样硬化基础上，斑块破裂，触发血小板激活和凝血酶生成，引起血栓形成，造成管腔的次全或完全闭塞。动脉粥样硬化基本病理改变是以胆固醇酯为主的脂质成分在动脉壁的沉积，动脉粥样硬化的治疗重点在于斑块的消退如何通过药物治疗降低血液中胆固醇水平等机制，对动脉粥样硬化斑块产生影响是人们关注的焦点。近年来的动物实验和临床研究都发现，长期(1年以上)应用他汀类药物治疗，不仅可以改善患者的脂质代谢紊乱，而且可以延缓、阻止动脉脉粥样硬化的发展，甚至对已经形成的粥样硬化斑块具有逆转和消退作用。血脂康是由中药红曲精制而成的，是HMG-CoA还原酶抑制剂类调脂药物，主要成分是洛伐他汀类，其成分还包括13种天然复合他汀及多种不饱和脂肪酸和氨基酸，具有改善脂质代谢，改善内皮功能的作用，但其长期应用是否对动脉粥样硬化斑块的稳定和消退产生作用尚需进一步研究，对于心肌梗死患者颈动脉粥样硬化的长期作用更是少见报道。因此，本研究拟将血脂康用于心肌梗死患者中，应用周围血管超声技术观察药物对斑块稳定和消退的疗效以及对心肌梗死患者颈动脉结构和功能的影响并探讨其相关的机制。目的1．观察长期服用血脂康对心肌梗死患者降血脂的作用。2．观察长期服用血脂康对心肌梗死患者颈动脉粥样硬化斑块的消退作用，并探讨其可能的机制。3．观察长期服用血脂康对心肌梗死患者颈动脉结构和功能的影响，并探讨其可能的机制。研究方法1．研究对象及分组：65例心肌梗死患者随机分为治疗组和对照组，治疗组在常规药物治疗的基础上服用血脂康2粒，0.6g，每日2次。对照组在常规药物治疗的基础上服用安慰剂2粒，每日2次。受试期间两组患者均保持与受试开始时相似的饮食习惯及生活方式，不服用其他影响血脂代谢的药物，原用于治疗冠心病、高血压或其他合并症的药物可继续应用。平均治疗时间(5.58±1.05)年(3.5年～7年)，服药6～8周后及服药后每6个月复诊，复诊时对受试者进行详细的问诊，并进行健康教育和生活方式指导。2．血脂检查所有受试者治疗前和结束后均抽取空腹静脉血，采用常规方法测量胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的水平(mmol／L)，同时检测肝肾功能和肌酸肌酶(CK)等安全性指标。治疗期间定期(半年)检测血脂及肝肾功能和肌酸激酶(CK)。3．高频超声检查：所有患者治疗前后均进行颈动脉超声检查，监测颈动脉内膜-中层厚度(IMT)、颈动脉斑块粥样硬化指数、颈总动脉收缩期内径(DS)、舒张期内径(DD)、收缩期峰值流速(PSV)、舒张末期流速(EDV)、阻力指数(RI)、搏动指数(PI)、血流剪切率(SR)和颈动脉弹性特征的指标，横断面顺应性(CSC)、扩张性系数(DC)、容积扩张性(VD)、顺应性(COM)、僵硬指数(SI)。4．统计学处理：应用统计软件SPSS11.5进行统计分析，计数资料以例数和百分比描述，计量资料以均数±标准差(?±s)表示，两组间计数资料比较用χ~2检验，计量资料比较采用t检验，以P＜0.05为差别具有显著性意义。结果1．研究对象一般情况的比较：共65例患者入选研究，两组患者共因心血管事件或失访而中断治疗10例，其中血脂康治疗组2例，1例因服药后自觉恶心及胃肠道不适而退出，1例因1月后复查肝酶指标谷丙转氨酶(ALT)升高为56IU／L(≤3倍)而要求退出研究：安慰剂对照组8例，因服药后自觉胃肠道不适症状退出2例，再次发生非致命性心肌梗死等冠心病事件4例，死亡2例。最终两组共有55例完成研究，血脂康治疗组30例，安慰剂对照组25例。两组患者在试验开始时基本情况(年龄、体重指数、血压、心率、性别构成比、吸烟史、饮酒史及合并高血压、糖尿病病史)以及合并用药(阿司匹林、β受体阻滞剂、血管紧张素转换酶抑制剂、硝酸脂类、钙拮抗剂)等方面均匹配良好(P＞0.05)，具有可比性。2．两组患者治疗前后体重指数(BMI)比较均无显著性差异(P＞0.05)。3．血脂水平：治疗后服用血脂康组血清TC、TG、HDL-C、LDL-C的水平浓度都不同程度的改善，TC、TG、LDL-C的水平与同组治疗前和对照组治疗后比较有显著下降，HDL-C水平与治疗前和对照组治疗后比较有显著升高，差异有显著性(P＜0.05)。安慰剂对照组治疗前后TC、TG、HDL-C、LDL-C水平无明显变化，无统计学意义(P＞0.05)。4．高频超声：(1)与治疗前和对照组比较，治疗后血脂康组颈动脉内-中膜厚度(IMT)、斑块指数明显降低(P＜0.05)，对照组治疗前后无统计学差异；(2)血流动力学参数的比较，治疗后PSV、EDV和SR在血脂康治疗组明显高于安慰剂对照组，而RI、PI明显低于对照组(P＜0.05)。(3)颈动脉弹性特征参数的比较，治疗后血脂康组患者SI明显低于对照组(P＜0.05)，DC和VD明显高于对照组(P＜0.05)，而CSC和COM在两组比较差异无统计学意义(P＞0.05)。结论1．血脂康作为国产他汀类药物可以显著的降低血清TC、TG、LDL-C水平，并升高HDL-C水平。2．长期服用血脂康可减缓或阻止动脉粥样硬化的进展，对已形成的动脉粥样硬化斑块具有逆转和消退作用，调节脂质代谢、改善内皮功能、改善血流动力学，增大剪切率是血脂康逆转和消退动脉粥样硬化斑块的主要机制。3．长期服用血脂康对大动脉弹性也有一定的保护作用。4．高频超声检查可作为观察动脉粥样硬化斑块的变化的可靠性方法。背景冠心病是目前世界范围内危害最大的心脏病，是目前中国成人心脏病住院和死亡的第一位原因，其发病率和死亡率依然呈上升趋势。近年来的资料表明，冠心病在我国不仅住院人次逐年快速上升，且住院平均费用列于各种疾病之首。冠心病的基础病变是动脉粥样硬化，动脉粥样硬化病变的进展，特别是易损斑块的破裂导致的血小板聚集和血栓形成是急性冠心病事件(急性冠脉综合征、冠心病猝死)的主要原因。冠心病二级预防是冠心病防治工作的基本策略之一，目标是减少冠心病和冠心病等危症人群发生或再次发生急性事件的危险，保护心肌，提高冠心病患者生存率和生存质量。旨在降低冠心病病残率和病死率以及一系列心脑血管事件的发生的各种药物治疗，其理论基础是抗动脉粥样硬化病变。目前而言，国内外已经有许多大规模的临床实验证明，调脂治疗可以对动脉粥样硬化取得较好的疗效，积极的降脂治疗在动脉粥样硬化导致的冠心病的防治中的首要地位已经得到广泛的认可。他汀类药物是HMG-CoA还原酶的抑制剂，通过竞争性的抑制HMG-CoA还原酶，抑制甲羟戊酸的产生，从而抑制胆固醇的合成。研究发现他汀类药物治疗不但可以减慢动脉粥样硬化病变的进展速度，而且可以减退存在的病变。这一发现无疑对冠心病二级预防治疗有重要的意义。4S、CARE、LIPID、WOSCOPS、AFCAPS／Tex CAPS、HPS、LIPS、Post-CABG、MIRACL、PROSPE等他汀类药物大规模的临床实验以令人信服的证据表明他汀类药物不但可以明显降低TC、TG和LDL-C，适当升高HDL-C，而且对于冠心病的一级和二级预防有明显的作用，可显著减少致命或非致命性心肌梗死、心血管死亡，减少对PCI和CABG的需要及减少脑卒中的发病率，降低总死亡率。血脂康是我国自主研制的他汀类药物，由中药红曲精制而成的，是HMG-CoA还原酶抑制剂类调脂药物，主要成分是洛伐他汀类，其成分还包括13种天然复合他汀及多种不饱和脂肪酸和氨基酸，具有改善脂质代谢，改善内皮功能的作用，已经开始应用于冠心病的二级预防。目的1．观察长期服用血脂康对心肌梗死患者降血脂的作用。2．研究长期服用血脂康对冠心病的二级预防作用。方法1．研究对象及分组：选择1997年5月至2002年2月在山东大学齐鲁医院诊断为心肌梗死的患者119例，其中男性92例，女性27例，均符合WHO关于心肌梗死诊断标准。采用双盲、随机、安慰剂对照长期随访临床试验，随机分为治疗组和对照组，治疗组在常规药物治疗的基础上服用血脂康2粒，0.6g，每日2次。对照组在常规药物治疗的基础上服用安慰剂2粒，每日2次。受试期间两组患者均保持与受试开始时相似的饮食习惯及生活方式，不服用其他影响血脂代谢的药物，原用于治疗冠心病、高血压或其他合并症的药物可继续应用。服药6～8周后及服药后每6个月复诊，复诊时对受试者进行详细的问诊，并进行健康教育和生活方式指导。2．血脂检查所有受试者治疗前和结束后均抽取空腹静脉血，采用常规方法测量胆固醇(TC)、甘油三脂(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)的水平(mmol／L)，同时检测肝肾功能和肌酸肌酶(CK)等安全性指标。治疗期间定期(半年)检测血脂及肝肾功能和肌酸激酶(CK)。3．治疗期间发生临床事件的比较两组患者研究期间评定发生的临床事件，临床主要终点事件为冠心病事件(非致死性心肌梗死和冠心病死亡)，次要终点为总死亡。4．治疗期间两组安全指标以及发生的不良事件评价安全性指标包括肌酸激酶(CK)、谷丙转氨酶(ALT)、谷草转氨酶(AST)、γ-谷氨酰基转肽酶(GGT)、肌酐(Cr)、尿素氮(BUN)、尿酸(UA)、胆红素(TBIL)、血细胞分析、尿常规，不良事件包括肌病的发生、横纹肌溶解、肌红蛋白尿、CK高于正常上限5倍以及ALT、AST高于正常上限3倍。5．统计学处理：应用统计软件SPSS10.0进行统计分析，计数资料以例数和百分比描述，计量资料以均数±标准差(?±s)表示，两组间计数资料比较用χ~2检验，计量资料比较采用t检验，以P＜0.05为差别具有显著性意义。结果1．研究对象：两组患者在试验开始时基本情况(年龄、体重指数、血压、心率、性别构成比、吸烟史、饮酒史及合并高血压、糖尿病病史)以及合并用药(阿司匹林、β受体阻滞剂、血管紧张素转换酶抑制剂、硝酸脂类、钙拮抗剂)等方面均匹配良好，无显著性差异(P＞0.05)，具有可比性。见表1。2004年12月31日结束随访，人选患者平均随访4年，最长随访时间为7年。2．血脂水平：治疗后服用血脂康组血清TC、TG、HDL-C、LDL-C的水平浓度都不同程度的改善，TC、TG、LDL-C的水平与同组治疗前和对照组治疗后比较有显著下降，HDL-C水平与治疗前和对照组治疗后比较有显著升高，差异有显著性(P＜0.05)。安慰剂对照组治疗前后TC、TG、HDL-C、LDL-C水平无明显变化，无统计学意义(P＞0.05)。3．临床事件方面119例心肌梗死患者经过平均4年随访研究发现，总共有20例冠心病事件发生，总死亡率21例，其中冠心病事件和总死亡数在血脂康组发生率分别为4.42％(3例)和6.67％(4例)，而在安慰剂组冠心病事件和总死亡发生率分别为18.64％(11例)与20.34％(12例)。两组冠心病事件和总死亡率分别比较，差异均有统计学意义(P＜0.05)。4．临床不良反应和实验室指标异常方面：血脂康组有2例服药后发生胃肠道反应，2例ALT、AST轻度升高(≤正常值上限3倍)，1例CK轻度升高(≤正常值上限3倍)，安慰剂组服药后出现胃肠道不适症状2例，1例ALT轻度升高(≤正常值上限3倍)，1例CK轻度升高(≤正常值上限5倍)。两组患者未发现Cr、BUN、UA、TBIL、血细胞分析以及尿常规等实验室指标的异常，两组患者未发现横纹肌溶解、肌红蛋白尿的病例。两组间临床不良反应和实验室指标异常方面差异无统计学意义(P＞0.05)。结论1．血脂康作为国产他汀类药物可以显著的降低血清TC、TG、LDL-C水平，并升高HDL-C水平。2．血脂康能显著降低冠心病心肌梗死患者的冠心病事件与总死亡的发生率，长期服用血脂康治疗对于冠心病二级预防的作用是值得肯定的，冠心病患者可以从长期血脂康的治疗中获益，而且随时间的延长获益逐渐增大。3．长期服用血脂康调脂治疗对于大多数中国患者而言是安全的。更多还原

【Abstract】 BackgroundAngiocardiopathy and cerebrovascular diseases are common and multi-onset disease, which have serious effects on the health of human beings, and has been be the first cause of death of human beings, and their pathological basis is atherosclerosis (AS). AS occurs in large and moderate arteries generally, example coronary artery and carotid artery. Recent studies show that there are same causative agents in coronary artery disease and carotid artery disease, and there are compact association between Carotid atherosclerosis and coronary atherosclerosis, their progression are horizontal. Traditionary, the development of AS was thought to be a line procedure, which lipids infiltrated into the intima to sharp plaques, the plaques increased by degrees and put in lumens at last, so the lumens would be narrowed and cause ischemic of the tissue. Therefore, it would result in the occurrence of acute cardiovascular accidents eventually. The occurance of myocardial infarction is based on coronary atherosclerosis, the plaque disrupted and thrombus formation, which caused the coronary occlusion completely.The pathological changes of AS are the lipids deposit in the arteries, which the most are cholesteryl esters. Now humans are focusing on the mechanisms of how to decrease the cholesterol levels and influence atherosclerotic plaques through drug therapies, long-term (beyond one years) effect of statins, not only decrease the levels of lipids, but also slow down or prevent the development of atherosclerosis, even fade away and reverse the atherosclerosis plaque which had come into being..Xuezhikang (XZK) is extracted from red rice which belongs to the traditional Chinese medicine, its main component is lovastatin, and include 13 kinds of natural compound statins and some kinds of unsaturated fatty acid and amino acids. Xuezhikang (XZK) has the effect of improve the lipids metabolism and the function of endothelium. However, it should be investigated penetrating that whether long-term treatment of XZK can benefit to stabilize and fade away the atherosclerotic plaques, and few report was publiced about the effect of XZK on carotid atherosclerosis in patients with myocardial infarction. Therefore, the aim of this study is to investigate the possibility and mechanisms of long-term treatment of XZK in stabilizing and fading away the carotid atherosclerotic plagues and the effect of structure and function of carotid in patients with myocardial infarction by the peripheral vessels ultrasound techniques. Objectives1. To research long-term treatment of XZK in decreasing lipids levels in patients with myocardial infarction.2. To investigate the long -term effect of XZK on carotid atherosclerosis in patients with myocardial infarction, and explore the mechanism.3. To investigate the long -term effect of XZK on structure and function of carotid, and explore the mechanism.Methods1. Characters of all subjects: Sixty-five patients with myocardial infarction were randomly divided into two groups. One group was given capsule of XZK 0.6g, two times a day in addition to conventional therapy. While others took the placebo two times a day in addition to conventional therapy. During the period, all patients kept the similar eating habits from the strart, and prohibited the drugs which can affect lipids metabolism. But the drugs which benefit to coronary artery disease, hypertension or others complication can be used. The mean follow-up The mean follow-up period was 5.58±1.05 years(3.5~ 7 years). The arrangement visited every 6 months. In every visit the doctors inquired all patients at length, and guide their life style.2. Laboratory examination: At the beginning of the experiment and after treatment, blood samples were collected for measuring the lipid profile. While liver enzymes and CK were measured too. Every 6 months the lipid profile, liver enzymes and CK were measured at interval.3. Ultrasound examinations: All patients’ carotids were examined with high-frequency ultrasound checked before and after treatment. IMT, the index of atherosclerosis plaque, the common carotid artery diameter, the peak velocity in systolic stage(PSV), the end velocity in diastolic stage(EDV), resistence index(RI), pulsatility index (PI), maximal shear rate (SR), stiffness index (SI), cross-sectional compliance (CSC), distensibility coefficient (DC), compliance (COM), volume dilatancy (VD) were all measured.4. Statistic analysis: Continuous variables are reported as mean±deciazione standard (SD) and have been analysed by SPSS 11.5. Continuous variables have been compared using t test, categorical variables by x~2 test. For all analysis, a P value less than 0.05 was considered significant.Results1. Characters of all subjects: Sixty-five patients with myocardial infarction entered the study, but ten patients quit the treatment. In XZK group, one patient feeled nausea after took the capsule, ALT increased in another patient after one month, they quited the test. In control group, two patients feeled nausea after took the capsule, nonfatal myocardial infarction happened in four patients and two patients died. Eventually, fifty-five patients finished the test, thirty took XZK while twenty-five took placebo.There are no significant difference in all base line characters (P>0.05 ) .2. BMI had no significant difference between before and after treatment in two groups (P>0.05) .3. Lipid profile: In XZK group, the total cholesterol (TC), triglycerides (TG) and the low density lipoprotein cholesterol (LDL-C) were decreased, and the high density lipoprotein cholesterol (HDL-C) were increased after treatment (P<0.05); While in control group, lipid profile had no significant difference (P>0.05).4. Ultrasound measurement: (1) Values of IMT and the index of atherosclerosis plaque in XZK group were lower than before treatment or control group (P<0.05). While in control group, lipid profile had no significant difference (P>0.05). (2) Compared with control group, resistence index and pulsatility index were significantly lower and the peak velocity in systolic stage, the end velocity in diastolic stage and maximal shear rate were significantly higher in XZK group (P<0.05). (3) Compared with control group, stiffness index was significantly lower volume dilatancy and distensibility coefficient and were significantly higher in XZK group (P<0.05), there were no significant difference of cross-sectional compliance and compliance in two groups (P>0.05).. Conclusions1. XZK can significantly decrease TC TG and LDL-C significantly, and increaseTC, TG LDL-C.2. Long-term treatment of XZK can slow down or prevent the development of carotid atherosclerosis, fade away and reverse the carotid atherosclerosis plaque, which the main mechanism is adjust the lipid profile, improve the function of endothelium and increase the shear rate.3. Long-term treatment of XZK can improve arterial elasticity.4. High frequency ultrasound imaging technique provides a reliable method in monitoring the change and rupture of plaques. BackgroundCoronary heart disease (CHD) is the hazardest heart disease in the world, which is first reason to be in hospital and to die in the adult now, the rate of morbidity and mortality is increasing. Recent studies show that the patients with CHD are increasing, but also the average cost because of hospitalization is the most in all disease. The pathological basis of CHD is atherosclerosis (AS), the progress of AS, in particular platelet aggregation and arterial thrombosis because of plaque disruption are recognized as critical to the acute coronary event (acute coronary syndrome, sudden coronary death).The secondary prevention of CHD is the one of basic tactics in the prevention and cure of CHD, which the object is reduce the occurance of acute event in patients with CHD, protect the cardiac muscle, increase the rate and quality of exist. At present, there are a lot of large scale clinical trial exterior and interior show that decrease lipid have a benefit to AS, which are recognized as critical to the prevention and cure of CHD. Statins can inhibit the synthesis of cholesterol. Recent studies show that statins can slow down or prevent of atherosclerosis, what’s more it can fade away and reverse the atherosclerosis which have existed. Therefore, it is very significant to the secondary prevention of CHD. The large scale clinical trial about statins example of 4S, CARE, LIPID, WOSCOPS, AFC APS/Tex CAPS, HPS, LIPS, Post-CABG, MIRACL, PROSPE show that statins can not only decrease TC, TG, LDL-C and increase HDL-Csignificantly, but also do a benefit to the primary prevention and secondary prevention of CHD.Xuezhikang(XZK) is extracted from red rice which belongs to the traditional Chinese medicine, its main component is lovastatin, and include 13 kinds of natural compound statins and some kinds of unsaturated fatty acid and amino acids. Xuezhikang (XZK) has the effect of improve the lipids metabolism and the function of endothelium. XZK has been used to the secondary prevention of CHD.Objectives1. To research long-term treatment of XZK in decreasing lipids levels in patients with myocardial infarction.2. To study the secondary prevention effect of Xuezhikang on coronary heart CHD. Methods1. Characters of all subjects: One hundred nineteen patients with myocardial infarction were randomly divided into two groups. One group was given capsule of XZK 0.6g, two times a day in addition to conventional therapy. While others took the placebo two times a day in addition to conventional therapy. During the period, all patients kept the similar eating habits from the strait, and prohibited the drugs which can affect lipids metabolism. But the drugs which benefit to coronary artery disease, hypertension or others complication can be used. The arrangement visited every 6 months. In every visit the doctors inquired all patients at length, and guide their life style.2. Laboratory examination: At the beginning of the experiment and after treatment, blood samples were collected for measuring the lipid profile. While liver enzymes and CK were measured too. Every 6 months the lipid profile, liver enzymes and CK were measured at interval.3. The primary end-points were nonfatal myocardial infarction and deaths from CHD. Total death rate were monitored. 4. Side effects and abnormal laboratory references: Creatine kinase (CK), glutamic pyruvic transaminase (ALT), glutamic oxalacetic transaminase (AST), glutamyl transpeptidase (GGT), creatinine (Cr), urea nitrogen (BUN), uric acid (UA), bilinxbinic acid (TBIL), analysis of blood cell were monitored. Whether the occurrence of myopathic, rhabdomyolysis, myoglobinuria, abnormal ALT, AST and CK were observed.5. Statistic analysis: Continuous variables are reported as mean ± deciazione standard (SD) and have been analysed by SPSS 10.0. Continuous variables have been compared using t test, categorical variables by x~2 test. For all analysis, a P value less than 0.05 was considered significant.Results1. Characters of all subjects: The patients with myocardial infarction entered the study, there are no significant difference in all base line characters (P>0.05). The study is closed on December 31,2004. The mean follow-up period was 4 years, and the longest subject is 7 years.2. Lipid profile: In XZK group, the total cholesterol (TC), triglycerides (TG) and the low density lipoprotein cholesterol (LDL-C) were decreased, and the high density lipoprotein cholesterol (HDL-C) were increased after treatment (P<0.05); While in control group, lipid profile had no significant difference (P>0.05).3. There were 20 patients happened nonfatal myocardial infarction and deaths from CHD, and 21 patients died. The incidence of the primary end-points and the total mortality in XZK group were 4.42% (n=3) and 6.67% (n=4), compared with 18.64% (n=11) and 20.34% (n=12) in the control group. There were significant difference between the two group (P<0.05).4. Side effects and abnormal laboratory references: In XZK group, two patients feeled nausea after took the capsule, ALT and AST increased in two patients after one month, but not beyond three doubles of the normal, CK increased in another patients while not beyond five doubles of the normal. In control group, two patients feeled nausea after took the capsule, ALT increased in one patient after one month, but not beyond three doubles of the normal, CK increased in another patients while not beyond five doubles of the normal. Myopathic, rhabdomyolysis, myoglobinuria were not observed, and there were no significant differences in side effects and abnormal laboratory reference between groups.Conclusion1. XZK can significantly decrease TC TG and LDL-C significantly, and increase TC TG, LDL-C.2. Compares to placebo, Xuezhikang can significantly decrease the incidence of nonfatal myocardial infarction or deaths from CHD. It can also reduce the total mortality. It show that XZK do a benefit to patients with CHD.3. It is safe for the most patients with CHD in China to long-term treatment of XZK更多还原