丹参酮ⅡA磺酸钠联合阿托伐他汀钙对冠心病心力衰竭的影响
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摘要
目的:观察丹参酮ⅡA磺酸钠联合阿托伐他汀治疗冠心病心力衰竭的临床疗效。方法:将64例冠心病心力衰竭患者随机分为对照组和观察组,各32例,对照组予阿托伐他汀钙,10 mg/次,1次/d;观察组在对照组的基础上给予丹参酮ⅡA磺酸钠注射液80mg+5%葡萄糖注射液250m L静脉滴注,1次/d。2组均于治疗4周后,观察临床疗效、不良反应及治疗前后心功能、氧化应激、血管活性物质水平的变化情况。结果:总有效率观察组为87.50%,对照组为62.50%,2组比较差异有统计学意义(P<0.05)。每分钟排血量(CO)、心脏指数(CI)、左心室射血分数(LVEF)、左心室舒张末期内径(LVEDd)、超氧化物歧化酶(SOD)、丙二醛(MDA)、一氧化氮(NO)、血管内皮生长因子(VEGF)、内皮素1(ET-1)、血管性血友病因子(VWF)等指标治疗前后2组组内比较,差异有统计学意义(P<0.05);治疗后2组组间比较差异也有统计学意义(P<0.05)。不良反应发生率观察组为6.25%,对照组为12.50%,2组比较差异无统计学意义(P>0.05)。结论:丹参酮ⅡA磺酸钠联合阿托伐他汀钙治疗冠心病心力衰竭患者临床疗效显著,安全性高,可改善心功能,这可能与抑制氧化应激反应、改善血管内皮功能有关。
Objective:To observe clinical effects of sodium tanshinon ⅡA silate joined with atorvastatin in treating coronary heart disease heart failure. Methods:All 64 patients were randomly allocated to the control group and the observation group, 32 cases each group, the control group were treated by atorvastatin, 10 mg each time,once each day; the observation group received intravenous dripping of sodium tanshinonⅡA silate injection, 80 mg and 5% dextrose injection, 250 mL, once each day, on the foundation of the therapy the control group accepted. The levels of vaso-active substance, oxidative stress, heart function before and after treating, adverse reaction and clinical effects of both groups were observed after they were treated for four weeks. Results: Total effective rate of the observation group was 87.50%, higher than 62.50% of the control group, and the difference was statistically significant(P<0.05). The difference had statistical meaning in the comparisons of cardiac output(CO), cardiac index(CI), left ventricular ejection fraction(LVEF), left ventricular end diastolic dimension(LVEDd), SOD, MDA,NO, VEGF, ET-1 and VWF within two groups before and after treating(P <0.05); the difference had statistical meaning in the comparisons between both groups after treating(P<0.05). The incidence of adverse reaction of the observation group was 6.25%, lower than 12.50% of the control group, and the difference had no statistical meaning(P>0.05). Conclusion: Sodium tanshinon ⅡA silate joined with atorvastatin is effective in treating coronary heart disease heart failure with high safety, which could improve cardiac function, and this might be related to inhibiting oxidative stress reaction and improving vascular endothelial function.
Objective:To observe clinical effects of sodium tanshinon ⅡA silate joined with atorvastatin in treating coronary heart disease heart failure. Methods:All 64 patients were randomly allocated to the control group and the observation group, 32 cases each group, the control group were treated by atorvastatin, 10 mg each time,once each day; the observation group received intravenous dripping of sodium tanshinonⅡA silate injection, 80 mg and 5% dextrose injection, 250 mL, once each day, on the foundation of the therapy the control group accepted. The levels of vaso-active substance, oxidative stress, heart function before and after treating, adverse reaction and clinical effects of both groups were observed after they were treated for four weeks. Results: Total effective rate of the observation group was 87.50%, higher than 62.50% of the control group, and the difference was statistically significant(P<0.05). The difference had statistical meaning in the comparisons of cardiac output(CO), cardiac index(CI), left ventricular ejection fraction(LVEF), left ventricular end diastolic dimension(LVEDd), SOD, MDA,NO, VEGF, ET-1 and VWF within two groups before and after treating(P <0.05); the difference had statistical meaning in the comparisons between both groups after treating(P<0.05). The incidence of adverse reaction of the observation group was 6.25%, lower than 12.50% of the control group, and the difference had no statistical meaning(P>0.05). Conclusion: Sodium tanshinon ⅡA silate joined with atorvastatin is effective in treating coronary heart disease heart failure with high safety, which could improve cardiac function, and this might be related to inhibiting oxidative stress reaction and improving vascular endothelial function.
引文
[1]油瑞琴.利尿剂治疗慢性收缩性心力衰竭应注意的问题[J].基层医学论坛,2011,15(29):966-967.
[2]梁峰,沈珠军.冠心病合并急性心力衰竭的诊治现状和展望[J].临床内科杂志,2016,33(1):16-20.
[3]杨涵,段淼,孙世光.他汀类药物治疗心血管疾病的非降脂作用研究进展[J].中国循证心血管医学杂志,2011,3(3):233-234.
[4]范广俊,范青,赵珊,等.丹参酮ⅡA理化性质的研究[J].药学服务与研究,2008,8(4):295-296.
[5]杨华,岳庆丽,孙红梅,等.丹参酮IIA磺酸钠联合稳心颗粒治疗冠心病心绞痛室早临床疗效[J].中国美容医学,2012,21(16):199-200.
[6]龚洁.冠心病防治指南[M].武汉:湖北科学技术出版社,2012:83.
[7]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:53-56.
[8]董卢忠.生脉和丹参注射液联合应用治疗心力衰竭60例临床观察[J].中国现代药物应用,2009,3(22):116-117.
[9]李亚,艾智华.他汀类药物对糖尿病心血管保护作用的研究进展[J].西南军医,2016,18(6):569-571.
[10]王丹妮,馀绍萍,刘莉.丹参酮ⅡA磺酸钠注射与盐酸莫西沙星氯化钠注射液存在配伍禁忌[J].医学美学美容,2014,1(5):501-503.
[11]田丰永,王锦鹏,徐涛,等.丹参酮ⅡA磺酸钠联合阿托伐他汀治疗冠心病心力衰竭的疗效及对患者血清Treg、IL-10、TGF-β水平的影响[J].河北医药,2016,38(2):193-195.
[12]蒋伟哲,孔晓龙,段小群,等.龙眼参对机体氧自由基清除作用的研究[J].中国药房,2001,12(8):453-454.
[13]张利,杨锐英.血尿酸升高及氧化应激在冠心病发生中的作用[J].宁夏医学杂志,2007,29(3):205-207.
[14]赵大国,范国印,王留义.辛伐他汀对冠心病合并充血性心力衰竭患者血管内皮功能的影响[J].中国煤炭工业医学杂志,2007,10(8):909-910.
[15]张秀洲,刘福艳,李静,等.冠心病患者血管生成因子变化与冠状动脉侧支循环的相关性研究[J].中国保健营养,2014,24(7):3677-3678.
[16]张雪莲.v W因子与糖尿病微血管并发症[J].微循环学杂志,2002,12(3):37-39.
[2]梁峰,沈珠军.冠心病合并急性心力衰竭的诊治现状和展望[J].临床内科杂志,2016,33(1):16-20.
[3]杨涵,段淼,孙世光.他汀类药物治疗心血管疾病的非降脂作用研究进展[J].中国循证心血管医学杂志,2011,3(3):233-234.
[4]范广俊,范青,赵珊,等.丹参酮ⅡA理化性质的研究[J].药学服务与研究,2008,8(4):295-296.
[5]杨华,岳庆丽,孙红梅,等.丹参酮IIA磺酸钠联合稳心颗粒治疗冠心病心绞痛室早临床疗效[J].中国美容医学,2012,21(16):199-200.
[6]龚洁.冠心病防治指南[M].武汉:湖北科学技术出版社,2012:83.
[7]郑筱萸.中药新药临床研究指导原则[M].北京:中国医药科技出版社,2002:53-56.
[8]董卢忠.生脉和丹参注射液联合应用治疗心力衰竭60例临床观察[J].中国现代药物应用,2009,3(22):116-117.
[9]李亚,艾智华.他汀类药物对糖尿病心血管保护作用的研究进展[J].西南军医,2016,18(6):569-571.
[10]王丹妮,馀绍萍,刘莉.丹参酮ⅡA磺酸钠注射与盐酸莫西沙星氯化钠注射液存在配伍禁忌[J].医学美学美容,2014,1(5):501-503.
[11]田丰永,王锦鹏,徐涛,等.丹参酮ⅡA磺酸钠联合阿托伐他汀治疗冠心病心力衰竭的疗效及对患者血清Treg、IL-10、TGF-β水平的影响[J].河北医药,2016,38(2):193-195.
[12]蒋伟哲,孔晓龙,段小群,等.龙眼参对机体氧自由基清除作用的研究[J].中国药房,2001,12(8):453-454.
[13]张利,杨锐英.血尿酸升高及氧化应激在冠心病发生中的作用[J].宁夏医学杂志,2007,29(3):205-207.
[14]赵大国,范国印,王留义.辛伐他汀对冠心病合并充血性心力衰竭患者血管内皮功能的影响[J].中国煤炭工业医学杂志,2007,10(8):909-910.
[15]张秀洲,刘福艳,李静,等.冠心病患者血管生成因子变化与冠状动脉侧支循环的相关性研究[J].中国保健营养,2014,24(7):3677-3678.
[16]张雪莲.v W因子与糖尿病微血管并发症[J].微循环学杂志,2002,12(3):37-39.