灯盏花素注射液对慢性肺心病急性加重期血浆环核苷酸及内皮素1的影响

Effects of breviscapini injection on plasma cyclic nucleotide acid and endothelin-1 in the treatment of chronic cor pulmonale at acute phase

目的探讨灯盏花素注射液对慢性肺原性心脏病急性期血浆环核苷酸和内皮素的含量变化与临床的关系。方法将符合诊断标准的100例患者随机分为治疗组50例和对照组50例,对照组使用敏感抗生素,常规止咳、祛痰、平喘,心功能不全者加用地高辛或利尿剂。治疗组除按对照组治疗方法处理外,加用灯盏花素注射液50mg,1次/d,2组疗程为14d。结果(1)治疗组临床控制、显效、好转和无效率分别为36%、34%、20%、10%,总有效率为90%;对照组分别为22%、24%、22%和32%,总有效率为68%,治疗组疗效明显优于对照组(P<0.05)。(2)治疗组治疗后血浆黏度及全血高切黏度较对照组明显降低(P<0.05),动脉血氧分压(PaO2)和动脉血氧饱和度(SaO2)较对照组明显升高(P<0.05)。(3)治疗组治疗后,血浆环鸟苷酸(cGMP)、内皮素1(ET1)含量下降,环腺苷酸(cAMP)及cAMP/cGMP升高(P<0.05)。结论灯盏花素能够显著改变患者血液流变学,改善心功能及可能使cAMP、cGMP、ET1改变,以促进血管舒张,降低肺动脉压。

Objective To investigate the correlation between clinical conditions and levels of plasma endothelin-1 （ET-1） and plasma cyclic nucleotide acid in patients with chronic cor pulmonale at acute phase treated by breviscapini injection.Methods 100 patients with chronic cor pulmonale at acute phase were randomly divided into two groups, treatment group （n=50） and control group （n=50）. All patients were treated with antibiotics to relieve cough and asthma and remove sputum, patients with heart failure were treated with digoxin or diuresis besides the therapy mentioned above. The patients in treatment group, on the basis of treatment of control group, were treated with previscapini injection,50mg once a day intravenously,with a treatment course of 14 days for both groups. Results （1） The control rate, effective rate, improved rate, ineffective rate and total effective rate in treatment group were 36% ,34% ,20%, 10% and 90% respectively, however, which in control group were 22%, 24%, 22%, 32% and 68% respectively, the therapeutic effect of treatment group was superior to that of control group （P〈0.05）. （2）In the treatment group the blood viscosity, high shear rate viscosity were obviously decreased, as compared with those of control group （P〈0.05）, however, the arterial oxygen pressure and arterial oxygen saturation were significantly increased after treatment,as compared with those of control group （P〈0.05）. （3） Plasma cGMP and ET-1 levels in treatment group were decreased after treatment, while cAMP and cAMP/cGMP were increased （P〈0.05）. Conclusion Breviscapini injection could remarkably change the hemorrheology, improve cardiac function and change the levels of cAMP, cGMP and ET-1 so as to promote vasodilatation decreas,, pulmonary artery pressure.