丹参多酚酸盐治疗老年冠心病心绞痛疗效及对血脂代谢、血流动力学和心肌谱酶水平的影响

Efficacy of Salvianolate on Elderly Angina Pectoris of Coronary Heart Disease and Its Influence on Blood Lipid Metabolism,Hemodynamics and Myocardial Enzyme Spectrum

目的探讨丹参多酚酸盐治疗老年冠心病心绞痛的效果及对血脂代谢、血流动力学及心肌酶谱的影响。方法招募2017年1月—2018年12月医院心内科收治的120例冠心病心绞痛患者,随机分为对照组与观察组各60例,对照组给予常规抗心绞痛治疗,观察组在此基础上加用注射用丹参多酚酸盐治疗,1次/d,连续2周,比较两组疗效,并采集治疗前后血标本,测定总胆固醇(TC)、甘油三酯(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)等血脂指标及全血比黏度高切、血浆比黏度、血小板黏附率等血流动力学指标与谷草转氨酶(AST)、肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、肌钙蛋白(cTnI)、乳酸脱氢酶(LDH)等心肌酶谱指标的变化,统计治疗前后心绞痛发作频率、持续时间及硝酸甘油治疗情况的变化,记录治疗不良反应发生率。结果(1)观察组心绞痛及心电图疗效分组均优于对照组(P<0.05);(2)治疗后,两组TC、TG、LDL-C、全血比黏度高切、血浆比黏度、血小板黏附率、AST、CK、CK-MB、cTnI、LDH降低,HDL-C上升,(P<0.05),观察组治疗后TC、TG、LDL-C、全血比黏度高切、血浆比黏度、血小板黏附率、AST、CK、CK-MB、cTnI、LDH低于对照组,HDL-C高于对照组(P<0.05);(3)治疗后,观察组发作频率、硝酸甘油用量均少于对照组,心绞痛发作持续时间短于对照组(P<0.05);(4)两组不良反应发生率相近,差异无统计学意义(P>0.05)。结论注射用丹参多酚酸盐治疗老年冠心病心绞痛疗效高,可改善患者血脂代谢、血流动力学及心肌酶谱,安全性肯定。

Objective To investigate the effects of salvianolate on elderly angina pectoris of coronary heart disease and its influence on blood lipid metabolism,hemodynamics and myocardial enzyme spectrum.Methods A total of 120 patients with angina pectoris of coronary heart disease admitted to department of cardiology of the hospital from January 2017 to December 2018 were recruited.The patients were randomly divided into control group and observation group,with 60 cases in each group.The control group was given conventional anti-angina pectoris and the observation group was additionally treated with salvianolate for injection on this basis,once a day for 2 weeks.The efficacy was compared between the two groups,and blood samples were collected before and after treatment,and the blood lipid indicators including total cholesterol(TC),triglyceride(TG),high-density lipoprotein cholesterol(HDL-C)and low-density lipoprotein cholesterol(LDL-C),hemodynamic parameters of whole blood high-shear specific viscosity,plasma specific viscosity and platelet adhesion rate and myocardial enzyme spectrum indexes of aspartate aminotransferase(AST),creatine kinase(CK),creatine kinase isoenzyme(CK-MB),troponin(cTnI)and lactate dehydrogenase(LDH)were measured,and the frequency and duration of angina pectoris and nitroglycerin treatment were counted before and after treatment,and the incidence rate of adverse reactions was recorded.Results The efficacy classifications of angina pectoris and electrocardiogram in the observation group were better than those in the control group(P<0.05).After treatment,the levels of TC,TG,LDL-C,whole blood high-shear specific viscosity,plasma specific viscosity,platelet adhesion rate,AST,CK,CK-MB,cTnI and LDH were decreased while the level of HDL-C was increased(P<0.05),and the levels of TC,TG,LDL-C,whole blood high-shear specific viscosity,plasma specific viscosity,platelet adhesion rate,AST,CK,CK-MB,cTnI and LDH in the observation group after treatment were lower than those in the control group while the level of HDL-C was higher than that in the control group(P<0.05).After treatment,the frequency of attack and the amount of nitroglycerin in the observation group were lower than those in the control group,and the duration of angina pectoris was shorter than that in the control group(P<0.05).The incidence rate of adverse reactions was similar in the two groups(P>0.05).Conclusion Salvianolate for injection has high efficacy in treating elderly patients with angina pectoris of coronary heart disease.And it can improve blood lipid metabolism,hemodynamics and myocardial enzyme spectrum,and has positive safety.