舒血宁注射液对冠心病患者血液流变学和炎性因子的影响

Effects of Shuxuening injection on hemorheology and inflammatory factors in patients with coronary heart disease

目的:观察舒血宁注射液对冠心病患者血液流变学和炎性因子的影响。方法:238例冠心病患者随机分为治疗组(129例)和对照组(109例),对照组采用常规西药治疗;治疗组在常规治疗基础上给予舒血宁注射液20ml,用5%葡萄糖注射液稀释成250ml,静脉滴注,1次/d。两组患者均治疗14d为1疗程。结果:①治疗组总有效率(86.0%)显著好于和对照组(64.2%),P<0.05;②治疗后治疗组全血黏度高切变率[ηbH(3.8±1.1)mPa/s∶(5.9±1.2)mPa/s]、全血黏度低切变率[ηbL(12.8±2.1)mPa/s∶(15.2±2.0)mPa/s]、血浆比黏度[ηp(2.2±0.2)mPa/s∶(3.0±0.4)mPa/s]、全血还原黏度[ηH(10.8±2.2)mPa/s∶(13.9±3.5)mPa/s]、血细胞比容[HCT(0.7±0.1)∶(0.8±0.1)]和纤维蛋白原[Fib(4.0±0.9)g/L∶(4.4±1.1)]g/L均较治疗前明显下降(P均<0.05),而对照组治疗前后比较除HCT、Fib外其它指标差异无显著性(P>0.05);治疗后两组比较,治疗组除HCT、Fib外其它指标明显优于对照组(P<0.05);③治疗后两组白细胞介素-6[治疗组(23.5±14.5)ng/L∶(59.3±12.1)ng/L,对照组(40.3±16.2)ng/L∶(61.6±14.7)ng/L]、肿瘤坏死因子α[治疗组(40.3±16.2)ng/L∶(254.4±55.6)ng/L,对照组(127.5±31.8)ng/L∶(257.0±44.9)ng/L]和高敏C反应蛋白[治疗组(4.1±0.9)mg/ml∶(6.1±1.2)mg/ml,对照组(5.0±1.0)mg/ml∶(6.0±1.1)mg/ml]均较治疗前明显下降(P均<0.05),治疗后两组比较,治疗组各指标均明显优于对照组(P均<0.05);④治疗后治疗组的一氧化氮[NO(48.2±7.2)mmol/L∶(43.4±8.5)mmol/L]、内皮素[ET(82.7±7.3)ng/L∶(89.2±12.5)ng/L]及NO/ET[(0.58±0.14)∶(0.49±0.11)]均较治疗前有非常明显的改善(P均<0.05),而对照组治疗前后差异则无显著性(P均>0.05)。结论:舒血宁注射液能明显降低冠心病患者的血液黏度,炎性因子水平,进而调节血管内皮活性,增加供血量,显著提高疗效。

Objective： To investigate the effects of Shuxuening injection on hemorheology and inflammatory factors in patients with coronary heart disease （CHD）, Methods： A total of 238 eases with CHD were randomly divided into treatment group （n= 129） and control group （n= 109） . The control group was given routine therapy. The treatment group were given Shuxuening injection 20 ml （1 time/d, iv drop） based on routine therapy. The two group were trea- ted for 14d all. Results： （1）The total effective rate （86.0%） of treatment group was more than that of control group （64. 2%）, P〈O. 05; （2）After treatment, η/bH [（3. 8±1.1） mPa/s vs. （5.9±1.2） mPa/s], ηbL [（12. 8±2. 1） roPa/s vs. （15.2±2.0） mPa/s], r/p [ （2.2±0.2） mPa/s vs. （3.0±0.4） mPa/s], r/H [ （10.8±2.2） mPa/s vs. （13.9± 3.5） mPa/s], HCT [ （0.7±0.1） vs. （0.8±0.1）], and Fib [Fib （4.0±0.9） g/L vs. （4.4±1.1） g/L] in treat- ment group were significantly decreased compared with before therapy （P〈0.05 all） , while there were no significant difference except for HCT and Fib in control group （P〉0.05）. There were significant difference in above indexes ex- cept for HCT and Fib between the two groups after treatment （P〈0.05） ; （3）After treatment, IL--6 [treatment group （23.5±14.5） ng/L vs. （59.3±12.1） ng/L, control group （40. 3±6.2） ng/L vs. （61.6±14.7） ng/L], TNF-α [treatment group （40. 33±16.2） ng/L vs. （254.4±55.6） ng/L, control group （127.5±31.8） ng/L vs. （257. 0± 44. 9） ng/L], and hs--CRP [treatment group （4. 1：]=0. 9） mg/ml vs, （6.1±1.2） mg/ml, control group （5.0±1. 0） mg/ml vs. （6.0±1.1） mg/ml] in the two groups were significantly decreased （P〈0.05 all）, but the treatment group had a better result compared with control group （P〈20.05） ; （4）After treatment, NO [（48.2±7.2） mmol/L vs. （43.4 ±8.5） mmol/L], ET[（82.7±7.3） ng/Lvs. （89.2±12.5） ng/L], and NO/ET [（0. 58±0.14） vs. （0.49±0.11）] were significantly improved in treatment group （P〈0. 05 all）, but the control group no produced significant difference （P〉0. 05 all）. Conclusion： Shuxuening injection can significantly reduce blood viscosity, inflammatory factors, im- prove blood vassel endothelial function and increase blood stream and therapeutiz effect.