稳心颗粒联合低分子肝素治疗不稳定性心绞痛的疗效及对患者血管内皮功能与血液流变学的影响

Curative efficacy of Wenxin granules in combination with low molecular heparin in unstable angina pectoris and its effects on vascular endothelial function and hemorheology

目的探讨稳心颗粒联合低分子肝素治疗不稳定性心绞痛(unstable angina pectoris,UAP)的疗效及对患者血管内皮功能与血液流变学的影响。方法将140例符合纳入标准的不稳定性心绞痛患者采用随机数字法分为对照组70例和观察组70例。常规治疗基础上,对照组患者给予低分子肝素治疗,而观察组在对照组基础上联合给予稳心颗粒治疗。疗程结束后,比较对照组和观察组患者临床疗效、血管内皮功能指标及血液流变学指标。结果疗效评价显示,观察组患者治疗总有效率显著高于对照组(94.3%vs 82.8%,P<0.05)。治疗后,与对照组相比,观察组患者血管内皮功能指标内皮素(ET)水平降低[(85.9±12.2)vs(114.7±14.8)pg/m L],一氧化氮(NO)水平升高[(124.8±12.1)vs(82.5±10.2)μmol/L],血液流变学指标全血低切粘度、全血中切粘度、全血高切粘度、血浆粘度及纤维蛋白原水平降低[(7.05±1.13)vs(8.32±1.68)mPa·s,(5.25±0.43)vs(6.28±0.76)mPa·s,(4.54±0.50)vs(5.16±0.65)mPa·s,(1.25±0.13)vs(1.40±0.15)mPa·s,(2.47±0.80)vs(3.14±0.92)g/L],组间比较差异有统计学意义(均P<0.05)。结论稳心颗粒联合低分子肝素在不稳定性心绞痛中的应用效果良好,治疗有效率高,而且能够显著改善患者血管内皮功能和血液流变学指标。

Objective To investigate the clinical effect of Wenxin granules in combination with low molecular heparin in the treatment of patients with unstable angina pectoris（UAP） and its effects on vascular endothelial function and hemorheology. Methods 140 patients of UAP meeting the inclusion criteria were randomly divided into two groups equally by method of random number. Besides conventional drug treatments,the control group were given low molecular heparin,while the observation group were given Wenxin granules in combination with low molecular heparin. Then,the curative efficacy,vascular endothelial function and hemorheology indices between the two groups were compared. Results The observation group had a therapeutic efficiency ratio of 94. 3%,which was significantly higher than that of 82. 8% in the control group（P〈0. 05）. Compared with the control group,the observation group had statistically lower level of endothelin（ET） [（85. 9 ± 12. 2） vs（114. 7 ± 14. 8） pg/m L],higher level of nitrogen（NO） [（（124. 8 ± 12. 1） vs（82. 5 ± 10. 2） μmol/L]with both statistical differences（P〈0. 05）. As to hemorheology indices,levels of whole blood low shear viscosity,whole blood middle viscosity,whole blood high shear viscosity,plasma viscosity and fibrinogen in the observation group were statistically lower than those in the control group respectively[（7. 05 ± 1. 13） vs（8. 32 ± 1. 68） mPa·s,（5. 25 ± 0. 43） vs（6. 28 ± 0. 76） mPa·s,（4. 54 ± 0. 50）vs（5. 16 ± 0. 65） mPa·s,（1. 25 ± 0. 13） vs（1. 40 ± 0. 15） m Pa · s,（2. 47 ± 0. 80） vs（3. 14 ± 0. 92） g/L,all P〈0. 05） ]. Conclusion Wenxin granules in combination with low molecular heparin is effective for UAP,which could significantly increase the curative efficiency,improve vascular endothelial function and hemorheology indices.