麝香保心丸联合阿托伐他汀对老年冠心病患者心功能、氧化应激及miR-133、miR-499表达的影响

Effect of Shexiang Baoxin Pill combined with atorvastatin on cardiac function,oxidative stress and expression of miR-133 and miR-499 in elderly patients with coronary heart disease

目的:探究麝香保心丸联合阿托伐他汀对老年冠心病(CHD)患者心功能、氧化应激及微小RNA-133(miR-133)、miR-499表达的影响。方法:90例老年CDH患者,根据治疗方法不同分为对照组和观察组,每组各45例。对照组予以阿托伐他汀治疗;观察组予以麝香保心丸+阿托伐他汀治疗,疗程均为12周。比较两组患者临床疗效、治疗前后心功能[左心室射血分数(LVEF)、左心室收缩期末内径(LVESD)、左心室舒张期末内径(LVEDD)]、血清氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)、谷胱甘肽过氧化物酶(GSH-Px)]水平、miRNA-133和miRNA-499表达及不良反应发生情况。结果:观察组患者临床总有效率高于对照组(P<0.05)。治疗后,观察组患者LVEF及血清SOD、GSH-Px水平高于对照组(P<0.05);LVESD、LVEDD及血清MDA水平低于对照组(P<0.05);miR-133、miR-499表达水平低于对照组(P<0.05)。两组患者不良反应发生率比较,差异无统计学意义(P>0.05)。结论:麝香保心丸联合阿托伐他汀可提高对老年CDH患者的临床疗效,且安全性好,可有效改善患者心功能,减轻氧化应激、下调miR-133和miR-499的表达可能是其发挥疗效的作用机制。

Objective:To investigate the effect of Shexiang Baoxin Pill combined with atorvastatin on cardiac function,oxidative stress and expression of microRNA-133(miR-133)and miR-499 in elderly patients with coronary heart disease(CHD).Methods:90 elderly patients with CDH were divided into the control group and the observation group according to different treatment methods,with 45 cases in each group.The control group was treated with atorvastatin,the observation group was treated with Shexiang Baoxin Pill+atorvastatin for 12 weeks.The clinical efficacy,cardiac function[left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD)],serum oxidative stress indexes[superoxide dismutase(SOD),malondialdehyde(MDA),glutathione peroxidase(GSH-Px)]levels,miRNA-133 and miRNA-499 expressions,and adverse reactions were compared between the two groups before and after treatment.Results:The total clinical effective rate of the observation group was higher than that of the control group(P<0.05).After treatment,LVEF and serum SOD and GSH-Px levels in the observation group were higher than those in the control group(P<0.05).LVESD,LVEDD and serum MDA levels were lower than those in the control group(P<0.05),the expression levels of miR-133 and miR-499 were lower than those in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Shexiang Baoxin Pill combined with atorvastatin can improve the clinical efficacy of elderly patients with CDH,and has good safety.It can effectively improve the cardiac function of patients,reduce oxidative stress,and down-regulate the expression of miR-133 and miR-499,which may be the mechanism for its efficacy.