丹参酮ⅡA与瑞舒伐他汀联合对冠状动脉粥样硬化性心脏病合并颈动脉粥样硬化患者的疗效及对趋化素、p38-MAPK及核因子κB的影响

Efficacy of Tanshinone ⅡA Combined with Rosuvastatin on Patients with Coronary Heart Disease and Carotid Atherosclerosis and Its Effects on Chemokine, p38-MAPK and NF-κB

目的探讨丹参酮ⅡA与瑞舒伐他汀联合对冠状动脉粥样硬化性心脏病合并颈动脉粥样硬化患者的疗效及对趋化素、p38-MAPK及核因子κB的影响。方法选取2017年10月至2018年10月辽宁省抚顺市新抚区医疗保障事务服务中心医院内科收治的150例冠状动脉粥样硬化性心脏病合并颈动脉粥样硬化患者作为研究对象,按照随机数字表法分为联合组和对照组,每组75例。对照组予以瑞舒伐他汀治疗,联合组在对照组治疗基础上增用丹参酮ⅡA治疗。比较两组疗效,治疗前后趋化素、p38-MAPK及核因子κB水平,治疗前后炎症介质水平,不良反应发生情况。结果联合组治疗后内膜中层厚度(IMT)、斑块面积以及斑块数量低于对照组(P<0.05)。联合组治疗后血清趋化素、p38-MAPK及核因子κB水平低于对照组(P<0.05)。联合组治疗后血清正五聚蛋白-3(PTX-3)以及白细胞介素-6(IL-6)水平低于对照组(P<0.05)。联合组与对照组恶心呕吐、疲乏、皮疹以及头痛发生率比较差异无统计学意义(P>0.05)。结论丹参酮ⅡA与瑞舒伐他汀联合对冠状动脉粥样硬化性心脏病合并颈动脉粥样硬化患者疗效显著,可明显下调趋化素、p38-MAPK及核因子κB水平,减轻炎症反应,且安全性较好。

Objective To investigate the efficacy of tanshinone IIA combined with rosuvastatin on patients with coronary heart disease complicated with carotid atherosclerosis, and the effects on chemokine, p38-MAPK and transcription factor protein(NF-κB).Methods A total of 150 patients with coronary heart disease complicated with carotid atherosclerosis admitted to Department of Internal Medicine, Medical Security Service Center Hospital, Xinfu District, Fushun Liaoning from October 2017 to October 2018 were selected as research objects and were divided into a combined group and a control group according to the random number table method, with 75 cases in each group. The control group was treated with rosuvastatin, and combined group was given tanshinoneⅡA treatment on the basis of the control group. The efficacy, chemokine, p38-MAPK and NF-κB levels before and after treatment,inflammatory cytokines levels before and after treatment, and adverse reactions were compared. Results After treatment, IMT,plaque area and plaque number in the combined group were all lower than those in the control group(P<0.05). After treatment,serum levels of chemokine, p38-MAPK and NF-κB in the combination group were lower than those in the control group(P<0.05).After treatment, serum PTX-3 and IL-6 levels in the combined group were lower than control group(P<0.05). The incidence of nausea, vomiting, fatigue, rash and headache was not statistically significant between the combined group and the control group(P>0.05). Conclusion Tanshinone IIA combined with rosuvastatin has a significant therapeutic effect on patients with coronary heart disease complicated with carotid atherosclerosis. The levels of chemokine, p38-MAPK and NF-κB can be significantly down-regulated, and the inflammatory response can be reduced, and the safety is good.