丹参注射液联合酒石酸美托洛尔治疗老年冠状动脉粥样硬化性心脏病临床评价

Clinical Evaluation of Danshen Injection Combined with Metoprolol Tartrate in Treating Elderly Patients with Coronary Heart Disease

目的探讨丹参注射液联合酒石酸美托洛尔治疗老年冠状动脉粥样硬化性心脏病（简称冠心病）的疗效及对心功能、血浆脑钠肽（BNP）和血液流变学指标的影响。方法将医院收治的72例冠心病患者采用随机单盲的方式分为观察组和对照组,各36例。对照组患者给予丹参注射液治疗,观察组患者在对照组治疗基础上加用酒石酸美托洛尔治疗。比较两组患者的临床疗效及对患者心功能、血浆BNP和血液流变学等指标的影响。结果观察组总有效率为91.67%,明显优于对照组的69.44%（χ^2=7.31,P〈0.05）;治疗后,两组患者心率、心绞痛发作次数及持续时间和心功能较治疗前均有显著改善（P〈0.05）,观察组美国纽约心脏病学会（NYHA）心功能分级较治疗前显著改善（P〈0.05）,但对照组NYHA分级与治疗前无显著性差异（P〉0.05）,且观察组上述4项指标均较对照组改善更明显（t=6.71,8.35,6.95,8.15,P〈0.05）;两组患者血浆BNP及全血黏度（nbl）、血浆比黏度（np）、高切变率下全血黏度（nbh）、红细胞聚集指数（EAI）等血液流变学指标较治疗前均有显著改善,且观察组改善更明显（P〈0.05）。结论丹参注射液联合酒石酸美托洛尔治疗老年冠心病患者不仅能有效提高临床疗效,且能显著改善患者心功能、血浆BNP和血液流变学等各项指标,值得临床推广。

Objective To investigate the efficacy of Danshen Injection combined with metoprolol tartrate in the treatment of elderly patients with coronary heart disease and its influence on cardiac function,plasma brain natriuretic peptide（ BNP） and hemorheology.Methods 72 patients with coronary artery disease in the hospital were divided into the observation group and the control group by randomly single- blind method,36 cases in each group. The control group was given Danshen Injection while the observation group was added with metoprolol tartrate. The clinical outcomes and its impact on heart function,brain natriuretic peptide and blood rheology indicators were compared between the two groups. Results The total effective rate was 91. 67% of the observation group,which was significantly better than 69. 44% of the control group（ χ^2 = 7. 31,P〈0. 05）; after treatment,the heart rate,angina attack frequency,duration,and other aspects of cardiac function of the two groups had significantly improved than before treatment（ P〈0. 05）; the NYHA classification of the observation group improved（ P〈0. 05）,while the control group had no statistically significant difference（ P〈0. 05）. All of the 4 index in the observation group improved more significantly when compared with the control group（ t = 6. 71,8. 35,6. 95,8. 15,P〈0. 05）; The plasma BNP and whole blood viscosity（ nbl）,plasma viscosity（ np）,a wholly- high shear rate blood viscosity（ nbh）,erythrocyte aggregation index（ EAI） and other blood rheology were improved in the two groups,and the observation group improved more significantly（ P〈0. 05）. Conclusion Danshen Injection combined with metoprolol tartrate can not only improve the clinical efficacy but also can significantly improve the cardiac function and plasma BNP and other blood rheology indicators in the treatment of elderly patients with coronary heart disease,it is worthy of clinical promotion.