丹参多酚酸盐对蜂蜇伤致心肌损伤的保护作用

Protection effect of salvianolate in treatment of myocardial injury caused by bee sting

目的探讨丹参多酚酸盐对蜂蜇伤致心肌损伤的保护作用。方法将该院2008年1月至2013年12月收治的65例蜂蜇伤患者按随机分层原则分为两组,在西医常规治疗基础上,治疗组34例患者加用丹参多酚酸盐静脉滴注,对照组31例患者加用1,6-二磷酸果糖静脉滴注。同时,收集25例健康体检者空腹静脉血作为健康组进行比较。对比治疗组和对照组蜂蜇伤患者入院时、治疗48 h及7 d时的心肌酶学[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]指标,同时比较治疗组和对照组入院时、治疗7 d时及健康组的超敏C反应蛋白(hs-CRP)、丙二醛(MDA)、超氧化物歧化酶(SOD)、白介素-6(IL-6)水平。结果入院时治疗组、对照组患者各心肌酶学指标均有升高,但差异均无统计学意义(P>0.05);治疗48 h时,治疗组、对照组患者各心肌酶学指标较入院时均下降,但治疗组下降较对照组更明显,差异均有统计学意义(P<0.05);治疗7 d时,治疗组、对照组患者各心肌酶学指标开始逐渐恢复,但对照组略高于治疗组,差异均有统计学意义(P<0.05)。对照组、治疗组患者入院时MDA、SOD、hs-CRP、IL-6水平均较健康组高,差异均有统计学意义(P<0.05);而治疗组患者与对照组入院时MDA、SOD、hs-CRP水平比较,差异均无统计学意义(P>0.05),但治疗7 d时两组MDA、SOD、hs-CRP、IL-6水平比较,差异均有统计学意义(P<0.05)。结论丹参多酚酸盐对蜂蜇伤患者心肌损伤有较好的保护作用,其机制可能与抗氧化应激、抗炎有关。

Objective To investigate the protection effect of salvianolate in treatment of myocardial injury caused by bee sting. Methods A total of 65 patients with myocardial injury for bee sting of this hospital from January 2008 to December 2013 were randomly divided into two groups by layering. Based on the conventional western medicine treatment,the treatment group（34cases） was injected intravenously with salvianolate,the control group（31 cases） with 1,6 fructose diphosphate; meanwhile,the fasting venous blood of additional 25 healthy examinees were deemed as the control group. The parameters of myocardium enzy-mology such as CK,CK-MB,LDH of the patients between the two groups at the time of admission,48 h and 7 d after the treatment were compared as well as the level of hs-CRP,MDA,SOD,IL-6 at them time of admission,48 h and 7 d after the treatment. Results The parameters of myocardium enzymology of the two groups at the time of enrollment were significantly increased,but there was no significant difference between the two groups（P〉0.05）. After the 48 h treatment,the parameters of myocardium enzymology of the two groups were lower than those at the time of enrollment,demonstrating more obvious in the treatment group,there was statistically significant difference（P〈0.05）. After 7 d treatment,the parameters of myocardium enzymology of the two groups were recovered gradually. The treatment group were slightly higher than the control group concerning the above-mentioned parameters,whose difference was statistically significant（P〈0.05）. The MDA,SOD,hs-CRP,IL-6 levels at the time of admission were higher than those of the healthy normal group,whose difference was statistically significant（P〈0.05）. There was no statistical significance between the two groups concerning MDA,SOD,hs-CRP after the 48 h treatment（P〉0.05）,while it had statistical significance concerning MDA,SOD,hs-CRP and IL-6 after the 7 d treatment,whose difference was statistically significant（P〈0.05）.Conclusion Salvianolate in treatment of myocardial injury for bee sting shows a better protection effect,whose mechanism is probably related to oxidative stress resistance and anti-inflammatory.