亚硒酸钠和维生素E治疗高海拔地区心血管病患者远期疗效

The Observation of a Long-term Effects of Sodium Selenite and Vitamin E on Treatment of Cardiovascular Disease Patients in Altitude Areas

目的 :评价亚硒酸钠和维生素E(VitE)治疗高海拔地区心血管病患者远期疗效。方法 :两组按常规治疗的基础上 ,心血管病组 4 7例患者服用亚硒酸钠 ,0 .5mg d ,连服一周 ,以后每周0 .5mg ,同时服VitE ,10 0mg d ,3次 d ,疗程 6个月。对照组 30例 ,除未用亚硒酸钠及VitE外 ,其余同心血管病组。观察两组患者治疗前后血清硒 (Se) ,谷胱甘肽过氧化物酶 (GSH -PX)活力、丙二醛(MDA)、心肌酸磷酸激酶 (CK -MB)和心肌钙蛋白 (CTn -I)、总胆固醇 (TC)和甘油三酯 (TG)及免疫球蛋白 (IgG、IgA、IgM )等指标 ,随访 1.6年～ 3.1年 ,以观察远期疗效。结果 :治疗后心血管病组血清Se含量及GSH -PX 活力明显增加 (P <0 .0 1) ,MDA和TG、TC显著降低 (P <0 .0 1;P <0 .0 5 ) ,CK -MB、IgG基本恢复正常。完全缓解者心血管病组 36例 (76 .6 0 % ) ,对照组 9例(30 .0 0 % ) ;复发者心血管病组 6例 (16 .6 7% ) ,对照组 7例 (6 3.6 4% )。心血管病组远期疗效显著优于对照组 (P <0 .0 5 ) ,复发率显著低于对照组 (P <0 .0 5 )。结论 :用亚硒酸钠及VitE治疗高海拔地区心血管病患者 ,提高了缓解率 ,降低了复发率。提示Se含量减少可能有助于阐明高原环境下心血管病与缺硒关系的部分机理。

Objective:To evaluate the long-term effects of sodium selenite and vitaminE(VitE) on treatment of heart and blood vessel disease patients in altitude areas. Methods: The patients in two groups were treated by routine therapy.The 47 cases with cardiovascular disease was in the test group and they were treated with sodium selenite (0.5mg/day for one week, then 0.5mg/week for 6 months) and vitamin E (100mg/time, 3/day for 6 months) while the routine treatment was performed.The 30 cases matched as the test as the control group and no sodium selenite and vitamin E were given. The serum level of Se, plasma glutathione pexoxidase(GSH-P X),alondialdehyde(MDA), CTn-I and CK-MB, serum IgG,IgA,IgM, TC and TG were measured before and after treatment. Followed up 1.6～3.1 years. Results:After treatment, the level of Se and GSH-Px in the test group were significantly higher than that in control group (P<0.01), the level of MDA,TG,TC in the test group was decreased obviously (P<0.01;P<0.05). The level of CK-M and IgG was in a normal range. 36 cases in the test group were up to complete remission (76.60%) but 9 cases in the control (30.00%), 16.67% and 63.64% recurrent in the test and the control group separately. There was significantly difference between the two groups (P<0.05).Conclusions:The general remission rate is increased and the recurrent rate is decreased after treatment with sodium selenite and VitE. It is suggested that the reduction of Se could relate to the partial mechanisms between lacking Se and the heart and blood vessel disease at high altitude.