摘要
目的观察并比较丹参多酚酸盐对接受经皮冠状动脉介入术(PCI)的非ST段抬高型急性冠状动脉综合征(NSTE-ACS)患者的治疗效果、安全性和机制。方法选取2018年7月—2019年6月上海中医药大学附属岳阳中西医结合医院心血管内科行PCI治疗的NSTE-ACS患者86例,随机数字表法分为对照组和观察组,各43例。对照组PCI术后给予冠心病二级预防治疗,观察组在对照组治疗基础上给予丹参多酚酸盐静脉滴注,均持续治疗14 d。比较治疗前后2组患者临床疗效、心功能、心肌损伤标志物、内皮功能标志物水平,以及心血管事件和药物不良反应。结果观察组临床总有效率高于对照组(95.35%vs.83.72%,χ^(2/)P=9.183/0.031);治疗后2组LVEF均升高,但观察组高于对照组(t/P=10.102/0.000),观察组左心室整体纵向应变优于对照组(t/P=8.847/<0.001);2组治疗后CK-MB、cTnI和BNP水平均较治疗前明显降低,但2组比较差异无统计学意义(P>0.05);治疗后观察组血清NO水平高于对照组(t/P=47.090/<0.001),而ET-1和VWF水平低于对照组(t/P=26.481/0.001,8.603/0.001);2组均无心血管不良事件和药物不良反应。结论丹参多酚酸盐用于接受PCI治疗的NSTE-ACS患者,能够减少心绞痛发作,改善左心室收缩功能,其作用机制可能与改善血管内皮功能有关。
Objective To observe and compare the therapeutic effect,safety and mechanism of Salvia Miltiorrhiza Polyphenolate on non-ST-segment elevation acute coronary syndrome(NSTE-ACS)patients undergoing percutaneous direct coronary intervention(PCI).Methods From July 2018 to June 2019,86 patients with NSTE-ACS who underwent PCI treatment in the Department of Cardiovascular Medicine,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,were selected.They were randomly divided into control group and observation group,with 43 cases in each group.The control group was given secondary prevention treatment for coronary heart disease after PCI,and the observation group was given intravenous infusion of Salvia miltiorrhiza polyphenolate based on the treatment of the control group.The treatment was continued for 14 days.The clinical efficacy,cardiac function,myocardial injury markers,endothelial function markers,cardiovascular events and adverse drug reactions were compared between the two groups before and after treatment.Results The total clinical effective rate of the observation group was higher than that of the control group(95.35%vs.83.72%,χ^(2)/P=9.183/0.031);LVEF increased in both groups after treatment,but the observation group was higher than the control group(t/P=10.102/0.028),the overall longitudinal strain of the left ventricle in the observation group was better than that in the control group(t/P=8.847/<0.001);the levels of CK-MB,cTnI and BNP after treatment in the two groups were significantly lower than before treatment,but there was no statistical difference between the two groups Scientific significance(P>0.05);after treatment,the serum NO level of the observation group was higher than that of the control group(t/P=47.090/<0.001),while the levels of ET-1 and VWF were lower than those of the control group(t/P=26.481/0.001,8.603)/0.001);There were no adverse cardiovascular events or adverse drug reactions in both groups.Conclusion Salvia miltiorrhiza polyphenolate used in NSTE-ACS patients undergoing PCI treatment can reduce angina pectoris and improve left ventricular systolic function.Its mechanism of action may be related to improving vascular endothelial function.
作者
幸敬芬
崔海明
刘浩琪
伍锋
樊民
吴宗贵
Xing Jingfen;Cui Haiming;Liu Haoqi;Wu Feng;Fan Min;Wu Zonggui(Department of Cardiology,Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;不详)
出处
《疑难病杂志》
CAS
2021年第1期13-16,21,共5页
Chinese Journal of Difficult and Complicated Cases
基金
国家自然科学基金青年基金项目(81403258,81503371)。
关键词
急性冠状动脉综合征
非ST段抬高型
经皮冠状动脉介入术
丹参多酚酸盐
疗效
安全性
Acute coronary syndrome,non-ST-segment elevation
Percutaneous coronary intervention
Salvianolic acids
Therapeutic effect
Safety
Restenosis
