丹参多酚酸盐联合地尔硫卓治疗不稳定型心绞痛的疗效及对血清基质蛋白酶-9和髓过氧化物酶水平的影响
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摘要
目的探讨丹参多酚酸盐联合地尔硫卓治疗不稳定型心绞痛(UAP)疗效及对患者金属基质蛋白酶-9(MMP-9)和髓过氧化物酶(MPO)的影响。方法选取112例符合纳入标准的UAP患者作为研究对象,按随机数字表法分为对照组(n=56)和观察组(n=56)。所有入选病例均给予常规药物治疗。在此基础上,对照组患者给予地尔硫卓治疗,而观察组在对照组基础上给予丹参多酚酸盐治疗。疗程结束后,比较对照组和观察组患者临床疗效、心绞痛发作频率、每次发作持续时间、MMP-9和MPO水平。并于治疗期间,观察组间不良反应发生情况。结果观察组患者治疗总有效率明显高于对照组(94.6%比82.1%,P<0.05)。治疗后,与对照组相比,观察组患者心绞痛发作频率减少[观察组:(2.1±1.3)次/周,对照组:(4.2±1.1)次/周],每次发作持续时间缩短[观察组:(2.0±0.7)min,对照组:(3.7±1.3)min],MMP-9及MPO水平降低[观察组:(295.2±47.6)μg/L,对照组:(326.8±52.1)μg/L;观察组:(142.4±38.1)u/L,对照组:(161.5±40.8)u/L)],组间比较,差异均有统计学意义(均P<0.05)。治疗期间,对照组和观察组患者均未出现严重不良反应,对照组和观察组不良反应发生率分别为10.7%和16.1%,组间比较,差异无统计学意义(P>0.05)。结论丹参多酚酸盐联合地尔硫卓治疗UAP疗效可靠,可以明显提高临床疗效,减少心绞痛发生频率,缩短心绞痛发作持续时间,并降低机体MMP-9和MPO水平,且不良反应少。
Objective To investigate the clinical effect of salvianolate in combination with diltiazem in the treatment of patients with unstable angina pectoris( UAP) and its effects on matrix metalloproteinase 9( MMP-9) and myeloperoxidase( MPO). Methods 112 patients with UAP meeting the inclusion criteria who were admitted by our hospital from June 2014 to June 2015 were selected as research objects. According to the random number table,those patients were divided into the control group( n = 56) and the observation group( n = 56). Besides conventional drug treatments,the control group was given diltiazem,while the observation group was given salvianolate in combination with diltiazem. Then,the curative efficacy,frequency,the duration of angina pectoris,the levels of MMP-9,MPO,and observed incidences of adverse reactions were compared between groups. Results The observation group had a therapeutic efficiency ratio of 94. 6%,which was significantly higher than that of 82. 1% in the control group( P < 0. 05). Compared with the control group,seizure frequency of the observation group was statistically reduced [( 2. 1 ± 1. 3) vs( 4. 2 ± 1. 1)times/week) and the duration of UAP was statistically shorter [( 2. 0 ± 0. 7) vs( 3. 7 ± 1. 3) min) ]after the treatment( both P < 0. 05),and levels of MMP-9 and MPO of the observation group were statistically lower [( 295. 2 ± 47. 6) vs( 326. 8 ± 52. 1) μg/L,( 142. 4 ± 38. 1) vs( 161. 5 ± 40. 8) μg/L) ]. The differences were both statistically significant( P < 0. 05) in comparison between groups. During the treatments,there was no case of severe adverse reactions in both groups,and the incidencs of adverse reaction of the two groups were 10. 7% and 16. 1% respectively with no statistical difference( P > 0. 05). Conclusion Combined treatment of salvianolate with diltiazem for UAP is effective,which can significantly increase the curative efficiency,reduce seizure frequency,shorten the duration of angina pectoris and decrease the levels of MMP-9 and MPO with minor adverse reactions.
Objective To investigate the clinical effect of salvianolate in combination with diltiazem in the treatment of patients with unstable angina pectoris( UAP) and its effects on matrix metalloproteinase 9( MMP-9) and myeloperoxidase( MPO). Methods 112 patients with UAP meeting the inclusion criteria who were admitted by our hospital from June 2014 to June 2015 were selected as research objects. According to the random number table,those patients were divided into the control group( n = 56) and the observation group( n = 56). Besides conventional drug treatments,the control group was given diltiazem,while the observation group was given salvianolate in combination with diltiazem. Then,the curative efficacy,frequency,the duration of angina pectoris,the levels of MMP-9,MPO,and observed incidences of adverse reactions were compared between groups. Results The observation group had a therapeutic efficiency ratio of 94. 6%,which was significantly higher than that of 82. 1% in the control group( P < 0. 05). Compared with the control group,seizure frequency of the observation group was statistically reduced [( 2. 1 ± 1. 3) vs( 4. 2 ± 1. 1)times/week) and the duration of UAP was statistically shorter [( 2. 0 ± 0. 7) vs( 3. 7 ± 1. 3) min) ]after the treatment( both P < 0. 05),and levels of MMP-9 and MPO of the observation group were statistically lower [( 295. 2 ± 47. 6) vs( 326. 8 ± 52. 1) μg/L,( 142. 4 ± 38. 1) vs( 161. 5 ± 40. 8) μg/L) ]. The differences were both statistically significant( P < 0. 05) in comparison between groups. During the treatments,there was no case of severe adverse reactions in both groups,and the incidencs of adverse reaction of the two groups were 10. 7% and 16. 1% respectively with no statistical difference( P > 0. 05). Conclusion Combined treatment of salvianolate with diltiazem for UAP is effective,which can significantly increase the curative efficiency,reduce seizure frequency,shorten the duration of angina pectoris and decrease the levels of MMP-9 and MPO with minor adverse reactions.
引文
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[9]张凤,邱菊,张黎明,等.丹参多酚酸对急性脑梗死患者运动和认知功能影响的临床研究[J].中国临床保健杂志,2015,18(3):232-234.
[10]刘振,王昕,刘亮亮,等.益气逐瘀丸对气虚血瘀型不稳定型心绞痛患者CXCL16、MMP-9水平的影响[J].南京中医药大学学报,2015,31(4):314-316.
[11]赵伟,李婷婷,李莹,等.冠心病患者炎性因子水平与急性冠状动脉综合征的相关性分析[J].中华老年心脑血管病杂志,2014,16(2):207-208.
[12]王鹏,刘星,赵延恕,等.血清脂联素和基质金属蛋白酶-9联合检测对冠心病的诊断价值[J].医学临床研究,2015,32(5):1018-1021.
[13]张琳,董智强,岳乐,等.血浆髓过氧化物酶与P-选择素在冠状动脉粥样硬化性心脏病中的相关性研究[J].深圳中西医结合杂志,2015,25(18):19-21.
[14]张海生,汤子军,张文彬,等.血清髓过氧化物酶水平与急性冠脉综合征的关系[J].中华全科医学,2015,13(9):1420-1422.
[2]陈红娟,殷泉忠.丹参川芎嗪联合前列地尔对老年不稳定型心绞痛患者内皮功能的影响[J].中国老年学杂志,2015,35(15):4210-4211.
[3]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.不稳定型心绞痛和非ST段抬高心肌梗死诊断与治疗指南[J].中华心血管病杂志,2007,35(4):295-304.
[4]杨平.尼可地尔与单硝酸异山梨酯治疗不稳定型心绞痛的临床疗效分析[J].实用医院临床杂志,2015,12(1):98-100.
[5]熊晓荣.卡维地洛与地尔硫卓治疗不稳定型心绞痛疗效观察[J].新乡医学院学报,2015,32(1):44-47.
[6]张春.注射地尔硫卓对陈旧性心肌梗死后心绞痛的疗效观察[J].现代预防医学,2015,42(6):1139-1140,1151.
[7]罗敏,李向荣.丹参多酚酸盐联合尿激酶治疗STEMI后心绞痛的疗效分析[J].重庆医学,2015,44(32):4527-4528,4531.
[8]吴福荣,白霞,董旭涵,等.丹参多酚酸盐与辛伐他汀治疗老年不稳定型心绞痛临床疗效比较[J].西部医学,2015,27(3):352-355.
[9]张凤,邱菊,张黎明,等.丹参多酚酸对急性脑梗死患者运动和认知功能影响的临床研究[J].中国临床保健杂志,2015,18(3):232-234.
[10]刘振,王昕,刘亮亮,等.益气逐瘀丸对气虚血瘀型不稳定型心绞痛患者CXCL16、MMP-9水平的影响[J].南京中医药大学学报,2015,31(4):314-316.
[11]赵伟,李婷婷,李莹,等.冠心病患者炎性因子水平与急性冠状动脉综合征的相关性分析[J].中华老年心脑血管病杂志,2014,16(2):207-208.
[12]王鹏,刘星,赵延恕,等.血清脂联素和基质金属蛋白酶-9联合检测对冠心病的诊断价值[J].医学临床研究,2015,32(5):1018-1021.
[13]张琳,董智强,岳乐,等.血浆髓过氧化物酶与P-选择素在冠状动脉粥样硬化性心脏病中的相关性研究[J].深圳中西医结合杂志,2015,25(18):19-21.
[14]张海生,汤子军,张文彬,等.血清髓过氧化物酶水平与急性冠脉综合征的关系[J].中华全科医学,2015,13(9):1420-1422.