丹参酮ⅡA对充血性心力衰竭患者心功能和血管内皮细胞功能的干预研究

Investigation of Sodium Tanshione ⅡA on Cardiac Function and Vascular Endothelial Cell for Congestive Heart Failure

目的观察丹参酮ⅡA对充血性心力衰竭(心衰)患者心功能、血管内皮细胞功能的影响。方法入选68例慢性心衰患者根据纽约心脏病协会(NYHA)分级标准进行心功能分级,采用放射免疫法和双抗体夹心酶联免疫吸附法分别测定血管性假血友病因子(vWF)和6-酮-前列腺素F1a(6-keto-PGF1a),同时用比色法测一氧化氮(NO)、ELISA法检测N末端脑钠素原(NT-proBNP)、超声心动图测左室射血分数(LVEF),并与健康对照组28例进行比较。心衰患者随机分为常规组和丹参酮ⅡA组,2周后复查。结果心衰心功能Ⅲ级、Ⅳ级组与对照组比较,血NO、LN(NT-proBNP)及LVEF差异有统计学意义(P均<0.01);vWF和6-keto-PGF1a在对照组与心衰各心功能分级间差异均有统计学意义(P均<0.05)。治疗2周后,丹参酮ⅡA组心功能明显改善,与血浆vWF及6-keto-PGF1a含量分别呈正相关及负相关,且丹参酮ⅡA组较常规组LVEF明显增加,LN(NT-proBNP)及血NO明显降低(P均<0.05)。结论血管内皮细胞功能及vWF和6-keto-PGF1a与心衰严重程度有关,丹参酮ⅡA组可明显改善慢性心衰患者心功能,与血管内皮细胞功能改善有关。

Objective To observe the influence of Sodium Tanshione ⅡA on cardiac function and vascular endothelial cell for congestive hear t failure （CHF）. Methods Sixty-eight patients with CHF were studied, vWF was detected by radioactive immunity method,plasma 6-keto-PGFla and NT-proBNP was determined by ELISA, nitric oxide （NO） was detected by enzymic method,left ventricnlar ejection fraction （LVEF） was measured by ultrasonography. The results were compared with those of 28 healthy individuals. 65 patients were randomized to receive conventional therapy and Sodium Tanshione ⅡA therapy and were followed up for 2 weeks. Results There was significant difference in plasma NO, NT-proBNP and LVEF among healthy individuals and class Ⅲ or class Ⅳ （P〈0.01）. After treatment with Sodium Tanshione ⅡA,plasma vWF and 6-keto-PGFla was positively and negatively related with increasing of NYHA classification respectively, there was a significant difference in plasma vWF and 6-keto-PGFla concentration among healthy individuals,class Ⅱ ,class Ⅲ and classⅣ （P〈0.05） and there was a significantly greater increase in NYHA classification, LVEF and a greater decrease in LN （ NT- ProBNP） and Plasma NO （all P〈0.05）. Conclusion Plasma vWF and 6-keto-PGFla might be related with CHF.The treatment of patients with Sodium Tanshione ⅡA was effective, maybe it was related with the decrease of plasma NO.