丹参多酚酸盐对不稳定型心绞痛疗效及血浆TXA_2/PGI_2的影响
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摘要
目的:观察丹参多酚酸盐治疗不稳定型心绞痛患者的临床疗效,初步探讨其对血浆TXA_2/PGI_2的影响。
方法:我院心内科住院的不稳定型心绞痛患者60例,随机分为常规治疗组(n=30)和丹参多酚酸盐组(n=30)。两组均常规给予肠溶阿司匹林、普伐他汀及美托洛尔等治疗,丹参多酚酸盐组在上述治疗基础上加用丹参多酚酸盐(200mg+5%GS 250ml,静滴,每天一次);两组疗程均为2周。以健康体检者20例为正常对照组。临床疗效观察心绞痛症状(发作次数、程度、持续时间等)及含服的硝酸甘油量的变化;同时治疗前后各做一次心电图,观察ST段等改变情况。用药前后各采集空腹静脉血5ml,用ELISA法检测血栓素和前列环素的表达。
结果:(1)常规治疗组和丹参多酚酸盐组心绞痛症状疗效总有效率分别为63.3%、86.7%(P＜0.05),丹参多酚酸盐组心绞痛症状的改善明显优于常规治疗组;(2)常规治疗组和丹参多酚酸盐组心电图好转总有效率分别为60.0%、83.3%(P＜0.05),丹参多酚酸盐组心电图好转优于常规治疗组;(3)常规治疗组和丹参多酚酸盐组所含服的硝酸甘油停减率分别为53.3%、80.0%(P＜0.05),丹参多酚酸盐组硝酸甘油停减率明显优于常规治疗组;(4)与正常组比较,治疗前常规治疗组和丹参多酚酸盐组血浆TXA_2、TXA_2/PGI_2比值明显升高,PGI_2明显降低(P＜0.05),而常规治疗组和丹参多酚酸盐组之间无明显差别。(5)常规治疗组和丹参多酚酸盐组治疗后血浆TXA_2、TXA_2/PGI_2比值均较治疗前明显下降,PGI_2均较治疗前显著升高(P＜0.01);而丹参多酚酸盐组明显优于常规治疗组(P＜0.01)。(6)TXA_2和PGI_2呈显著负相关(P＜0.01)。
结论:丹参多酚酸盐能明显改善冠心病心绞痛患者的症状和心电图ST-T改变,其机制可能与丹参多酚酸盐抑制TXA_2分泌、促进PGI_2释放,纠正TXA_2/PGI_2失衡有关。
Objectives:To observe the effect of Salvianola on patients of unstable angina pectoris and study the influence of TXA_2 and PGI_2.
Methods:The study group was comprised of 60 patients from inpatient wards with unstable angina pectoris,who were randomly divided into routine treatment group(n=30)and Salvianola group(n=30). The patients of two groups were gave the routine treatment,involving in aspirin and provastatin and betaloc;whereas the patients of Salvianola group receiving the same treatment regimen plus Salvianola(200mg +5%GS250ml,ivgtt,Per day).The trial period was 14 days.Before and after the 14-day treatment,the clinical symptom was measured and electrocardiogram was performed;Meanwhile,the concentrations of thromboxan、prostacyclin in plasma were detected by ELISA.
Results:(1)The symptomatic effective rate of unstable angina pectoris in Salvianola group was 86.7%,which was higher than 63.3%in routine treatment group(P＜0.05);(2)The total ECG effective rate was 83.3%in Salvianola group,which was higher than 60.0%in routine treatment group(P＜0.05);(3)The stop-decrease rate of nitroglycerin was 80.0%in Salvianola group,which was higher than 53.3%in routine treatment group(P＜0.05);(4)Before the treatment,concentrations of TXA_2 and TXA_2/PGI_2 ratio in plasma in patients routine treatment group and Salvianola group were higher than those in normal group respectively, whereas the concentrations of PGI_2 was lower than that in normal group(P＜0.05).There was no significant difference between routine treatment group and Salvianola group;(5)After the treatment,the concentrations of TXA_2 and TXA_2/PGI_2 ratio in plasma in Salvianola group was significantly lower than those routine treatment group and before treatment,whereas the concentrations of PGI_2 was higher than those routine treatment group and before treatment(P＜0.01).(6)There were significantly negative correlations between the levels of TXA_2 and PGI_2 in blood serum(P＜0.01).
Conclusions:Salvianola can remarkably improve the symptoms of unstable angina pectoris;Salvianola can inhibit TXA_2 secretion and promote PGI_2 releasing,redress TXA_2/PGI_2 imbalance,this may be a mechanism of Salvianola therapeutic effect on unstable angina pectoris.
方法:我院心内科住院的不稳定型心绞痛患者60例,随机分为常规治疗组(n=30)和丹参多酚酸盐组(n=30)。两组均常规给予肠溶阿司匹林、普伐他汀及美托洛尔等治疗,丹参多酚酸盐组在上述治疗基础上加用丹参多酚酸盐(200mg+5%GS 250ml,静滴,每天一次);两组疗程均为2周。以健康体检者20例为正常对照组。临床疗效观察心绞痛症状(发作次数、程度、持续时间等)及含服的硝酸甘油量的变化;同时治疗前后各做一次心电图,观察ST段等改变情况。用药前后各采集空腹静脉血5ml,用ELISA法检测血栓素和前列环素的表达。
结果:(1)常规治疗组和丹参多酚酸盐组心绞痛症状疗效总有效率分别为63.3%、86.7%(P＜0.05),丹参多酚酸盐组心绞痛症状的改善明显优于常规治疗组;(2)常规治疗组和丹参多酚酸盐组心电图好转总有效率分别为60.0%、83.3%(P＜0.05),丹参多酚酸盐组心电图好转优于常规治疗组;(3)常规治疗组和丹参多酚酸盐组所含服的硝酸甘油停减率分别为53.3%、80.0%(P＜0.05),丹参多酚酸盐组硝酸甘油停减率明显优于常规治疗组;(4)与正常组比较,治疗前常规治疗组和丹参多酚酸盐组血浆TXA_2、TXA_2/PGI_2比值明显升高,PGI_2明显降低(P＜0.05),而常规治疗组和丹参多酚酸盐组之间无明显差别。(5)常规治疗组和丹参多酚酸盐组治疗后血浆TXA_2、TXA_2/PGI_2比值均较治疗前明显下降,PGI_2均较治疗前显著升高(P＜0.01);而丹参多酚酸盐组明显优于常规治疗组(P＜0.01)。(6)TXA_2和PGI_2呈显著负相关(P＜0.01)。
结论:丹参多酚酸盐能明显改善冠心病心绞痛患者的症状和心电图ST-T改变,其机制可能与丹参多酚酸盐抑制TXA_2分泌、促进PGI_2释放,纠正TXA_2/PGI_2失衡有关。
Objectives:To observe the effect of Salvianola on patients of unstable angina pectoris and study the influence of TXA_2 and PGI_2.
Methods:The study group was comprised of 60 patients from inpatient wards with unstable angina pectoris,who were randomly divided into routine treatment group(n=30)and Salvianola group(n=30). The patients of two groups were gave the routine treatment,involving in aspirin and provastatin and betaloc;whereas the patients of Salvianola group receiving the same treatment regimen plus Salvianola(200mg +5%GS250ml,ivgtt,Per day).The trial period was 14 days.Before and after the 14-day treatment,the clinical symptom was measured and electrocardiogram was performed;Meanwhile,the concentrations of thromboxan、prostacyclin in plasma were detected by ELISA.
Results:(1)The symptomatic effective rate of unstable angina pectoris in Salvianola group was 86.7%,which was higher than 63.3%in routine treatment group(P＜0.05);(2)The total ECG effective rate was 83.3%in Salvianola group,which was higher than 60.0%in routine treatment group(P＜0.05);(3)The stop-decrease rate of nitroglycerin was 80.0%in Salvianola group,which was higher than 53.3%in routine treatment group(P＜0.05);(4)Before the treatment,concentrations of TXA_2 and TXA_2/PGI_2 ratio in plasma in patients routine treatment group and Salvianola group were higher than those in normal group respectively, whereas the concentrations of PGI_2 was lower than that in normal group(P＜0.05).There was no significant difference between routine treatment group and Salvianola group;(5)After the treatment,the concentrations of TXA_2 and TXA_2/PGI_2 ratio in plasma in Salvianola group was significantly lower than those routine treatment group and before treatment,whereas the concentrations of PGI_2 was higher than those routine treatment group and before treatment(P＜0.01).(6)There were significantly negative correlations between the levels of TXA_2 and PGI_2 in blood serum(P＜0.01).
Conclusions:Salvianola can remarkably improve the symptoms of unstable angina pectoris;Salvianola can inhibit TXA_2 secretion and promote PGI_2 releasing,redress TXA_2/PGI_2 imbalance,this may be a mechanism of Salvianola therapeutic effect on unstable angina pectoris.
引文
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