丹参酮ⅡA磺酸钠联合辛伐他汀治疗冠心病心绞痛的疗效及对血液流变学和血清TNF-α、CRP、ET-1、NO水平的影响

Clinical Effect of Sodium Tanshinone ⅡA Sulfonate Combined with Simvastatin on Coronary Heart Disease with Angina Pectoris and Effects on the Hemorheology, Serum TNF-α, CRP, ET-1 and NO Levels

目的:探讨丹参酮ⅡA磺酸钠(STS)联合辛伐他汀(SV)治疗冠心病心绞痛(CHD-AP)的临床效果及对患者血液流变学和血清肿瘤坏死因子(TNF)-α、C反应蛋白(CRP)、内皮素(ET)-1、一氧化氮(NO)水平的影响。方法:选取我院2016年4月～2017年4月收治的210例CHD-AP患者,采取随机数字表法均分为两组。对照组予以SV治疗,观察组在此基础上加用STS治疗。记录比较两组的临床疗效,治疗前后血液流变学状态、血清TNF-α、CRP、ET-1、NO水平的变化及不良反应的发生情况。结果:治疗1个月后,观察组总有效率达91.4%,较对照组显著升高(78.1%,P<0.01)。两组治疗1个月后血浆黏度(PV)、全血黏度(WBV)、血小板黏附率(PAd T)值及血清TNF-α、CRP、ET-1水平较治疗前均显著降低(P<0.01),且观察组以上指标下降更显著(P<0.01)。与治疗前对比,两组治疗1个月后血清NO水平均显著上升(P<0.01);且观察组治疗后血清NO水平较对照组同期显著更高(P<0.01)。与对照组(2.9%)对比,观察组不良反应率为1.9%,差异无统计学意义(P>0.05)。结论:丹参酮ⅡA磺酸钠联合辛伐他汀治疗冠心病心绞痛更能有效缓解患者临床症状,疗效显著且安全可靠,可能与其显著改善患者血液流变学状态和血清中TNF-α、CRP、ET-1、NO水平有关。

Objective: To explore the clinical effect of sodium tanshinone ⅡA sulfonate(STS) combined with simvastatin(SV) on coronary heart disease with angina pectoris(CHD-AP) and its effects on the hemorheology, serum tumor necrosis factor(TNF)-α, C-reactive protein(CRP), endothelin(ET)-1 and nitric oxide(NO) levels. Methods: 210 cases with CHD-AP in our hospital from April 2016 to April 2017 were selected as research objectives and randomly divided into two groups. SV was provided to the control group and SV combined with STS was provided to the observation group. The clinical effect, changes of hemorheology, serum TNF-α, CRP, ET-1 and NO levels before and after treatment as well as adverse reaction were compared between two groups. Results: At 1 month after treatment,the overall effective rate was 91.4% in the observation group, which was significantly higher than that of the control group(78.1%, P<0.01).The plasma viscosity(PV), whole blood viscosity(WBV), platelet adhesion rate(PadT), serum TNF-α, CRP and ET-1 of both groups at 1 month after treatment were significantly lower than those before treatment(P<0.01), which decreased more significantly in the observation group(P<0.01). The serum NO level at 1 month after treatment was significantly higher than those before treatment(P<0.01), which was significantly higher in the observation group than that in control group(P<0.01). No statistical difference was found in the adverse reaction rate between two groups(1.9% vs. 2.9%, P>0.05). Conclusion: STS combined with SV showed better clinical effect on CHD-AP with high safety, which may attribute to improve the hemorheology, serum TNF-α, CRP, ET-1 and NO levels.