Compound Danshen injection improves endotoxin-induced microcirculatory disturbance in rat mesentery

AIM: To investigate the effect of compound Danshen injection on lipopolysaccharide (LPS)-induced rat mesenteric microcirculatory dysfunctions and the underlying possible mechanism by an inverted intravital microscope and high-speed video camera system. METHODS: LPS was continuously infused through the jugular artery of male Wistar rats at the dose of 2 mg/kg per hour. Changes in mesenteric microcirculation,such as diameters of arterioles and venules,velocity of RBCs in venules,leukocyte rolling,adhesion and emigration,free radicals released from post-capillary venules,FITC- albumin leakage and mast cell degranulation,were observed through an inverted intravital microscope assisted with CCD camera and SIT camera. Meanwhile,the expression of adhesion molecules CD11b/CD18 and the production of free radical in neutrophils,and the expression of intercellular adhesion molecule 1 (ICAM-1) in human umbilical vein endothelial cells (HUVECs) were quantified by flow cytometry (FACS) in vitro. RESULTS: The continuous infusion with LPS resulted in a number of responses in microcirculation,including a significant increase in the positive region of venulestained with Monastral blue B,rolling and adhesion of leukocytes,production of oxygen radical in venular wall,albumin efflux and enhanced mast cell degranulation in vivo,all of which,except for the leukocyte rolling,were attenuated by the treatment with compound Danshen injection. Experiments performed in vitro further revealed that the expression of CD11b/CD18 and the production of oxygen free radical in neutrophils,and the expression of ICAM-1 in HUVECs were increased by exposure to LPS,and they were attenuated by compound Danshen injection. CONCLUSION: These results suggest that compound Danshen injection is an efficient drug with multi-targeting potential for improving the microcirculatory disturbance.

Compound Danshen tablets downregulate amyloid protein precursor mRNA expression in a transgenic cell model of Alzheimer's disease Effects and a comparison with donepezil

After gene mutation, the pcDNA3.1/APP595/596 plasmid was transfected into HEK293 cells to establish a cell model of Alzheimer＇s disease. The cell model was treated with donepezil or compound Danshen tablets after culture for 72 hours. Reverse transcription-PCR showed that the mRNA expression of amyloid protein precursor decreased in all groups following culture for 24 hours, and that there was no significant difference in the amount of decrease between donepezil and compound Danshen tablets. Our results suggest that compound Danshen tablets can reduce expression of the mRNA for amyloid protein precursor in a transgenic cell model of Alzheimer＇s disease, with similar effects to donepezil.

The Protective Effect of Compound Danshen Dripping Pills on Oxidative Stress after Retinal Ischemia/Reperfusion Injury in Rats

Objective: To investigate the effect of Compound Danshen Dripping Pills (CDDP) on oxidative stress after ischemia/reperfusion (I/R) injury in the rat retina. Methods: Adult male SD rats were randomly divided into 3 groups: sham (group A), I/R (group B), and I/R plus CDDP (group C). Retinal ischemia/reperfusion injury (RIRI) was introduced by increasing the intraocular pressure (IOP) to 110 mmHg for 60 min via cannulation into the anterior chamber. Right after the insult, CDDP was administered intragastrically (450 mg/kg/d) for 7 days. The levels of malondialdehyde (MDA), the activities of superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), and catalase (CAT) in the retinal tissues were determined on d1 and d7 after the ischemic insult. Results: Following ischemia, the MDA levels in group B and group C were significantly higher than those in group A (p < 0.01). CDDP significantly lowered MDA levels in group C when compared with group B (p < 0.01). The activities of SOD, GSH-Px and CAT were higher in group A than in group B and group C (p < 0.01). CDDP could increase the activities of SOD, GSH-Px and CAT remarkably in group C when compared with group B (p < 0.01). Conclusion: CDDP can protect the retina from I/R injury through reducing oxidative stress, and thus may be a promising method for the treatment of ischemic retinal disorders.

Study on Determination of Tanshinones in Compound Danshen Tablets

[ Objective ] This study was conducted to improve quality standard of Compound Danshen tablets. [ Method] Tanshinones in Compound Danshen tab- lets were determined by HPLC method. [ Result] A good linear relationship was found in the range of 0.10 -0.50 μg, and the average recovery rate was 100.59% （RSD = 1.38% ）. [ Conclusion] The method is simple, rapid and reproducible, and could be used as a method for quality control of Compound Danshen Tablets.

Clinical Intervention Effect of Compound Danshen Dripping Pills on Aspirin Resistant Patients with Coronary Heart Disease

[Objectives]To study the clinical intervention effect of Compound Danshen Dripping Pills on aspirin-resistant patients with coronary heart disease(CHD).[Methods]240 patients with coronary heart disease who took Aspirin were selected to measure thrombocytopenia by sonoclot.They were randomly divided into four groups:group A(n=60),Compound Danshen Dripping Pills and aspirin.group B(n=60),aspirin;group C(n=60),high dose aspirin;group D(n=60),Compound Danshen Dripping Pills.CR and PF were determined by sonoclot after one month.The incidence of angina pectoris,acute myocardial infarction,sudden cardiac death and hemorrhage were observed.[Results]After treatment,the CR and PF levels of group A and C were significantly lower than those before treatment,and there was no significant difference between group B and D and before treatment.After treatment,the levels of CR and PF in group A and C were significantly lower than those in group B and D,and there was a significant difference.Angina pectoris and myocardial infarction events in group D were significantly higher than the other four groups;hemorrhage events in group C were significantly higher than the other three groups.[Conclusions]Compound Danshen Dripping Pills combined with aspirin can be used as an economical,effective,and more dependent alternative to inhibit platelet activity in aspirin resistance,and can further reduce the occurrence of acute coronary events.

Effect of Compound Danshen Injection Combined with Labetalol on Liver Function and Placental Growth Factor in Patients with Eclampsia

Objective: To explore the effect of Compound Danshen Injection combined with Labetalol on liver function and placental growth factor in patients with eclampsia. Methods: Seventy patients with eclampsia who were treated in the Hospital from February 2017 to February 2019 were enrolled. The patients were divided into two groups according to the random number table, with 35 cases in each group. The Observation group was treated with Labetalol, and the combined therapy group was treated with Compound Danshen Injection combined with Labetalol. The liver function [alanine aminotransferase, aspartate aminotransferase, total protein, and albumin], hemorheology indicators, placental growth factor and serum insulin-like growth factor-1 and clinical indicators in the two groups were analyzed. Results: After treatment, the levels of alanine aminotransferase and aspartate aminotransferase in the combined therapy group were significantly lower than those in the Observation group. The levels of total protein and albumin in the combined therapy group were significantly higher than those in the Observation group (P<0.05). After treatment, the high-cut and low-cut whole blood viscosity, plasma viscosity and erythrocyte rigidity index in the combined therapy group were significantly lower than the Observation group, and the difference was statistically significant (P<0.05). After treatment, the levels of PLGF and IGF-1 in the combined therapy group were significantly higher than those in the Observation group, and the difference was statistically significant (P<0.05). After treatment, the gestational age, neonatal weight index, placental weight and neonatal 1 min Apgar score in the combined therapy group were significantly higher than the Observation group, and the difference was statistically significant (P<0.05). Conclusion: For patients with eclampsia, Compound Danshen Injection combined with Labetalol is with great safety, which can help stabilize their condition, and improve their liver function and placental growth factor status.

Effects of compound danshen dripping pills on the levels of serum inflammatory factors, brain natriuretic peptide and blood lipid in CABG postoperative patients

Objective:To explore the effects of compound danshen dripping pills on the levels of serum inflammatory factors,brain natriuretic peptide(BNP)and blood lipid in CABG postoperative patients.Methods:156 cases of patients who were given CABG from January 2015 to January 2018 in Baogang Hospital were chosen and randomly divided into the observation group(n=78)and the control group(n=78).Both groups were given conventional drugs,simultaneously,the observation group was given compound danshen dripping pills.The treatment lasted 3 months.The clinical efficacy was compared between two groups of patients,and the levels of serum inflammatory factors,plasma BNP and blood lipid before and after treatment in two groups of patients were detected in order to make a comparison in the incidence of adverse cardiac events between two groups of patients.Results:After treatment,the total effective rate of treatment in the observation group was significantly higher than that in the control group;in the two groups,the levels of serum interleukin-6(IL-6),interleukin-8(IL-8),C-reactive protein and plasma BNP after treatment were obviously lower than those before treatment,and these indicators in the observation group were lower than those in the control group(p<.05);the levels of TG,TC and LDL-C in two groups were obviously lower(p<.05)with the level of HDL-C significantly higher(all p<.05),and the descending or ascending range of each indicator in the observation group was obviously larger than that in the control group(p<.05);in the follow-up visit,the incidence of adverse cardiac events in the observation group of patients was significantly lower than that in the control group of patients(p<.05).Conclusions:Compound danshen dripping pills can effectively reduce the levels of serum inflammatory factors and BNP,regulate blood lipid metabolism and reduce the incidence of adverse cardiac events in CABG postoperative patients.

Research survey and review of the effect of Compound Danshen Dripping Pills on the uric acid metabolism of patients with coronary heart disease

A growing number of studies have reported that serum uric acid（SUA） is associated with coronary heart disease（CHD）, which has been increasingly recognized and valued by the medical community. This paper surveys the epidemiological studies of hyperuricemia and CHD and summarizes the clinical study discussing the association between hyperuricemia and coronary heart disease with a prospect of exploring the possible mechanisms of compound Danshen dripping pills in reducing SUA in patients with coronary heart disease.

Protective Effects of Self-made Compound Taoren Danshen Decoction on Rats with Acute Liver Injury

[Objectives] To study the protective effects of self-made Compound Taoren Danshen Decoction( CTDD) on acute liver injury induced by D-galactosamine in rats,and to explore its mechanism. [Methods]An acute liver injury model was established by intraperitoneal injection of 500 mg/kg of D-galactosamine. The ALT,AST,MDA,SOD and GSH-Px in serum,as well as serum TNF-α,IL-1β and IL-6 levels were measured,and liver tissue lesions were observed under microscope. [Results] CTDD can significantly reduce ALT,AST and MDA levels,increase SOD,GSH-Px activity,and significantly reduce serum TNF-α,IL-1β and IL-6 levels,and improve liver tissue lesions.[Conclusions]CTDD has a protective effect on D-galactosamine-induced acute liver injury in rats,and its mechanism may be related to inhibition of oxidative stress and inflammatory reaction.

基于网络药理学和分子对接探究复方丹参滴丸治疗骨关节炎的作用机制

目的基于网络药理学和分子对接方法预测复方丹参滴丸(CDDP)治疗骨关节炎(OA)的作用机制。方法利用TCMSP数据库筛选CDDP主要化合物及靶点信息;查询GeneCards、OMIM、DisGenet数据库搜集OA相关蛋白靶点;利用Venn在线工具构建药物和疾病共同靶点;利用String 11.0平台构建蛋白质相互作用网络;采用Cytoscape 3.9.1软件构建药物-成分-靶点-疾病网络;使用R包clusterProfiler进行基因本体(GO)及京都基因与基因组百科全书(KEGG)通路富集分析;采用AutoDock Vina进行分子对接。结果CDDP与OA交集靶点有44个,KEGG通路富集发现,磷脂酰肌醇3-激酶/蛋白激酶B及白细胞介素-17信号通路等与药物作用通路相关;分子对接显示槲皮素、芹菜素和木犀草素与11个核心靶点结合良好,尤其槲皮素与金属蛋白酶9。结论CDDP可能通过多成分、多靶点、多通路共同发挥抗OA的作用.

复方丹参滴丸配合阿托伐他汀对冠心病患者行经皮冠状动脉介入术后血管内皮功能和血管炎性反应的影响

目的分析复方丹参滴丸配合阿托伐他汀对冠状动脉粥样硬化性心脏病(简称冠心病)患者行经皮冠状动脉介入术(percutaneous coronary intervention,PCI)后血管内皮功能和血管炎性反应的影响。方法选取2023年1月—2024年1月中南大学湘雅医院收治的94例冠心病患者为研究对象,所有患者均接受PCI,按治疗方法不同分组,每组47例。单药组采用阿托伐他汀治疗,联合组给予复方丹参滴丸、阿托伐他汀联合治疗,对比两组临床疗效、血管内皮功能、血管炎性反应。结果联合组临床总有效率为95.74%(45/47),高于单药组的74.47%(35/47),差异有统计学意义(χ^(2)=9.598,P<0.05)。治疗8周后,联合组的血管性血友病因子、内皮素-1、肿瘤坏死因子-α、白细胞介素-6、超敏C反应蛋白水平低于单药组,血清一氧化氮水平高于单药组,差异有统计学意义(P均<0.05)。结论冠心病患者PCI术后应用复方丹参滴丸配合阿托伐他汀治疗,可有效抑制炎症因子释放,改善血管内皮功能,临床疗效显著。

复方丹参滴丸联合阿托伐他汀钙治疗慢性心力衰竭临床观察

目的探讨复方丹参滴丸联合阿托伐他汀钙对慢性心力衰竭(congestive heart failure,CHF)患者心功能及细胞因子的影响。方法选取2020年8月—2022年8月就诊于济宁市中医院CHF患者92例进行研究,按照随机数字表法分为2组,各46例。对照组予以阿托伐他汀钙片进行治疗,观察组在对照组基础上采用复方丹参滴丸进行治疗,于治疗3个月后评估。对比2组临床疗效、心功能、细胞因子、血管活性物质、不良反应。结果观察组治疗总有效率(95.65%)高于对照组(80.43%),差异有统计学意义(P<0.05)。治疗前2组心功能、细胞因子、血管活性物质对比,差异无统计学意义(P>0.05);与对照组对比,观察组治疗后左室射血分数(left ventricular ejection fractions,LVEF)高,左室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、左室收缩末期内径(left ventricular end systolic diameter,LVESD)低,6 min步行距离(six minute walk distance,6MWD)长,可溶性生长刺激表达基因2蛋白(soluble growth stimulation expression gene 2 protein,sST2)、半乳糖凝集素-3(galectin-3)水平均低,内皮素-1(endothelin-1,ET-1)、血管紧张素Ⅱ(angiotensinⅡ,AngⅡ)、脑利钠肽(brain natriuretic peptide,BNP)水平均低(P<0.05)。观察组不良反应(13.04%)与对照组(10.87%)对比,差异无统计学意义(P>0.05)。结论CHF患者经复方丹参滴丸与阿托伐他汀钙治疗后心功能得到显著改善,且血清细胞因子水平趋于正常,血管活性物质生成有效一致,且安全性高。

复方丹参注射液联合西医治疗慢性肺源性心脏病心力衰竭疗效的Meta分析

目的:系统评价复方丹参注射液联合西医治疗肺源性心脏病心力衰竭的有效性和安全性。方法:检索中国知网、万方、维普、中国生物医学文献服务系统(SinoMed)、PubMed、the Cochrane Library、EMbase等数据库建库至2022年10月1日有关复方丹参注射液联合西医治疗肺源性心脏病心力衰竭的随机对照试验(RCT)。依据纳入及排除标准筛选得到相关文献,使用RevMan 5.4和Stata 14.0对纳入研究进行Meta分析。结果:共纳入29篇文献,涉及2879例病人,其中试验组1456例,对照组1423例。试验组总有效率高于对照组[RR=1.29,95%CI(1.25,1.34),P<0.001];试验组心率减慢时间[WMD=-3.08,95%CI(-3.66,-2.51),P<0.00001]、发绀缓解时间[WMD=-2.00,95%CI(-2.72,-1.28),P<0.00001]、水肿消退时间[WMD=-2.23,95%CI(-2.51,-1.96),P<0.00001]短于对照组;试验组血流动力学指标血细胞比容[WMD=-17.36,95%CI(-29.33,-5.39),P=0.004]、全血高切黏度[WMD=-1.55,95%CI(-2.03,-1.07),P<0.00001]、全血低切黏度[WMD=-3.04,95%CI(-3.91,-2.17),P<0.001]、血浆黏度[WMD=-0.21,95%CI(-0.23,-0.19),P<0.00001]、纤维蛋白原[WMD=-0.71,95%CI(-1.03,-0.39),P<0.001]低于对照组。结论:现有证据表明,复方丹参注射液联合西医治疗肺源性心脏病心力衰竭疗效显著且安全性较好。

复方丹参滴丸联合常规西医治疗冠心病合并糖尿病有效性及安全性的Meta分析

目的对复方丹参滴丸联合常规西医治疗冠心病合并糖尿病的有效性和安全性进行系统评价。方法通过检索万方数据库(Wanfang)、中国知网(CNKI)、维普中文期刊(VIP)、中国生物医学文献数据库(SinoMed),以及Cochrane Library、PubMed、Embase和Web of Science等数据库,收集从建库至2023年5月复方丹参滴丸联合常规西医治疗冠心病合并糖尿病的随机对照试验(RCT),由2位研究人员独立完成文献筛选、数据整理和偏倚风险评价;应用RevMan 5.4软件进行Meta分析。结果纳入24项RCT,共2546例患者。Meta分析结果显示,复方丹参滴丸联合常规西医治疗在提高冠心病合并糖尿病的总有效率[OR=4.93,95%CI(3.49,6.98),P<0.00001]、血浆脂联素[MD=2.79,95%CI(2.30,3.27),P<0.00001],降低空腹血糖[SMD=-1.06,95%CI(-1.24,-0.88),P<0.00001]、餐后2 h血糖[MD=-1.53,95%CI(-1.71,-1.35),P<0.00001]、糖化血红蛋白[MD=-1.56,95%CI(-2.01,-1.11),P<0.00001]、同型半胱氨酸[MD=-8.47,95%CI(-8.89,-7.97),P<0.00001]、低密度脂蛋白[MD=-0.46,95%CI(-0.69,-0.24),P<0.0001]、总胆固醇[MD=-0.45,95%CI(-1.11,-0.20),P=0.005]、甘油三酯[MD=-0.42,95%CI(-0.50,-0.34),P<0.00001]、白细胞介素6[SMD=-1.34,95%CI(-1.61,-1.07),P<0.00001]、心血管不良事件[OR=0.35,95%CI(0.19,0.64),P=0.0006]、不良反应发生率[OR=0.45,95%CI(0.24,0.86),P=0.01]方面均优于常规西医治疗。结论复方丹参滴丸联合西医常规治疗冠心病合并糖尿病的疗效优于单纯西医治疗,而且安全性较好。但受纳入研究质量等因素的限制,上述结论仍需更多高质量的临床试验验证。

对国家药品监督管理局公布的复方丹参片质量抽检不合格问题的分析和建议

目的:提取和整理国家药品监督管理局(NMPA)2016-2022年发布的复方丹参片抽检数据,梳理其质量不合格问题特点和趋势,为促进中成药提升质量提供参考。方法:在NMPA官网数据查询系统“全国药品抽检”界面,以“复方丹参片”作为关键词检索并提取抽检不合格相关信息。通过归类分析,统计复方丹参片质量不合格数据,并对涉事药品生产企业产品的不合格批次等进行分析。结果:共检索到54条本品不合格记录,涉及24家生产企业的46批产品,含量测定与重量差异未达标的批次占比分别为63.0%和34.8%。在含量测定未达标的29批产品中,主要不合格项目依次为三七含量(34.5%)、丹参酮IIA含量(20.7%)与丹酚酸B含量(20.7%)。药品不合格现象集中于某些生产企业,在涉及到的24家企业中,有6家(25.0%)出现3批或以上不合格产品,涉及不合格产品24批,占总不合格批次的52.17%。结论:自2017年至2022年,复方丹参片质量抽检不合格的批次与项目呈下降趋势,表明本品质量整体向好,但质量风险仍然存在,提示生产企业应持续加强内部质量控制,经销商应完善药品运输和储存过程管理,避免湿度等环境因素引起的质量变化。建议药品监督管理部门继续加强本品抽检与探索性研究,进一步提升复方丹参片的质量标准,保障公众用药质量。

复方丹参滴丸联合西医常规治疗冠心病心绞痛的回顾性队列研究

[目的]观察复方丹参滴丸联合西医常规治疗冠心病心绞痛的临床疗效,分析其临床疗效优势。[方法]采用回顾性队列研究方法,收集天津市6家医院病案管理系统中的冠心病心绞痛患者,采集时间为2014年1月—2022年6月。将这些患者分为暴露组和非暴露组,暴露组使用复方丹参滴丸联合西医常规治疗,非暴露组单独使用西医常规治疗,两组按照1∶1比例进行匹配,每组各612例。观察两组患者住院期间心血管事件发生率、临床生化指标及颈部血管彩超。[结果]暴露组谷草转氨酶、乳酸脱氢酶、C反应蛋白、凝血酶时间、D-二聚体、血糖、糖化血红蛋白、肌酐、尿酸、谷丙转氨酶、总胆红素、白细胞计数、颈动脉内中膜厚度、颈动脉斑块检出率低于非暴露组,差异具有统计学意义(P<0.05)。[结论]复方丹参滴丸联合西医常规治疗的冠心病心绞痛患者心血管事件发生率较低,凝血功能、肾功能、肝功能、血糖、血脂水平较稳定,颈动脉内中膜厚度较小,斑块发生率较低。

复方丹参滴丸联合羟苯磺酸钙治疗糖尿病性视网膜病变临床效果的meta分析

目的系统评价复方丹参滴丸辅助羟苯磺酸钙治疗糖尿病性视网膜病变(DR)的临床效果。方法检索中国知网、万方数据知识服务平台、维普网、中国生物医学文献服务系统、PubMed、Embase、Web of Science和Cochrane Library建库至2023年7月复方丹参滴丸联合羟苯磺酸钙治疗DR的临床随机对照试验。结果共纳入11项临床随机对照试验,共848例患者,观察组425例,对照组423例。meta分析结果显示,与对照组比较,试验组视野灰度值[均值差(MD)(95%CI):-0.92(-0.96,-0.88),P<0.00001]、血管瘤体积[MD(95%CI):-3.11(-3.33,-2.89),P<0.00001]、出血斑面积[MD(95%CI):-0.76(-0.85,-0.67),P<0.00001]、黄斑厚度[MD(95%CI):-55.62(-62.59,-48.65),P<0.00001]、血管内皮生长因子水平[MD(95%CI):-17.63(-21.6,-13.59),P<0.00001]、肿瘤坏死因子-α水平[MD(95%CI):-13.3(-16.09,-10.68),P<0.00001]更低,视力[MD(95%CI):0.13(0.05,0.20),P<0.00001]更好。无明显不良反应或事件发生。敏感性分析检验证实模型稳定性高,结论可信度高。结论根据目前临床证据,复方丹参滴丸与羟苯磺酸钙联用可提高DR的临床疗效。

基于决策树模型的复方丹参喷雾剂治疗冠心病心绞痛的经济学评价

目的:对复方丹参喷雾剂治疗冠心病心绞痛进行药物经济学评价,为卫生体系有限用药资源的合理配置提供参考依据。方法:基于TreeAge Pro软件,对复方丹参片vs.复方丹参喷雾剂治疗冠心病心绞痛进行成本-效果分析,成本参数源于米内网数据库和相关文献;同时根据一项Meta分析,研究两种治疗方案短期内的经济性;通过单因素敏感性分析、概率性敏感性分析对本研究结果的稳健性进行验证。结果:基础分析结果表明,相对于复方丹参片,使用复方丹参喷雾剂治疗冠心病心绞痛的患者每多提高10%的心电图有效率,需要多花费6.06元,此时若患者的意愿支付价格>6.06元,复方丹参喷雾剂更具有经济性,否则复方丹参片更具有经济性。敏感性分析对结果有一定的影响,验证了基础分析结果的稳健性,与基础分析结果一致。结论:基于2020年我国人均可支配收入(32189元)作为患者意愿支付阈值的假设,与复方丹参片相比,复方丹参喷雾剂在治疗冠心病心绞痛方面更具有经济性。

复方丹参滴丸对冠心病合并糖尿病患者介入治疗后造影剂肾病的预防作用

[目的]探讨复方丹参滴丸对冠心病合并糖尿病患者介入治疗后造影剂肾病(CIN)的预防作用。[方法]纳入天津市胸科医院心内三科2022年1月—2023年1月收治的冠心病合并糖尿病且行冠状动脉介入治疗的患者180例,采用简单随机分组方法,将入选患者随机分为观察组(90例)与对照组(90例)。对照组患者使用常规水化疗法预防CIN,观察组患者在对照组基础上应用复方丹参滴丸,比较两组患者的CIN发病率差异,比较两组患者治疗前及治疗后72 h肾功能:血肌酐(Scr)、尿素氮(BUN)、计算估算肾小球滤过率(eGFR)、血β2微球蛋白、尿中蛋白与肌酐比值(ACR)以及尿中性粒细胞明胶酶相关性脂蛋白(NGAL),炎性指标包括超敏C反应蛋白(hs-CRP)、白细胞介素6(IL-6),氧化应激指标包括超氧化物歧化酶(SOD)水平、丙二醛(MDA)水平的变化。对2组入选患者随访6个月,记录2组患者主要心脏不良事件(MACE)发生情况。[结果]1)复方丹参滴丸组CIN发病率低于对照组(4.4%vs 16.7%),差异有统计学意义(P<0.05)。2)治疗前,两组患者一般情况无差异(P>0.05)。与治疗前相比,两组患者治疗后72 h血肌酐、尿素、血β2微球蛋白、hs-CRP、IL-6、丙二醛水平、尿ACR、尿NGAL水平升高,而eGFR水平、SOD水平降低(P<0.05)。治疗后72 h,观察组肌酐、尿素、血β2微球蛋白、hs-CRP、IL-6、丙二醛水平、尿ACR、尿NGAL水平低于对照组,eGFR水平、SOD水平明显高于对照组(P<0.05)。3)随访6个月,观察组心脏MACE发生率低于对照组(10.0%vs 31.3%),差异有统计学意义(P<0.05)。4)多因素logistic回归分析显示,复方丹参滴丸对预防冠心病合并糖尿病的患者介入术后CIN有保护作用[OR=0.136,95%CI(0.035,0.527),P=0.004]。[结论]复方丹参滴丸对预防冠心病合并有糖尿病患者冠状动脉介入治疗后CIN的发生可能起到一定作用。

复方丹参滴丸对肾功能异常患者对比剂引发的急性肾损伤的保护作用

目的:探讨复方丹参滴丸对肾功能异常患者经皮冠状动脉介入治疗(PCI)后对比剂引发的急性肾损伤(CIAKI)的作用。方法:入选天津市胸科医院心内科2019年1月—2021年12月拟行PCI的肾功能异常冠心病患者590例,采用完全随机化法将其分为对照组和复方丹参滴丸组,各295例,分别给予水化、水化联合口服复方丹参滴丸(术前1 d起,每日3次,每次10粒)治疗。观察并比较2组入院时和对比剂使用后72 h肌酐(Cr)、尿素氮(BUN)、尿白蛋白、肾小球滤过率(GFR)、白细胞介素(IL)-6、超敏C反应蛋白(hs-CRP)、β_(2)微球蛋白和肿瘤坏死因子(TNF)水平,并记录两组CIAKI发生率。结果:两组术前各项观察指标差异均无统计学意义(均P>0.05),术后复方丹参滴丸组GFR显著高于对照组(t=-6.621,P<0.01),其余观察指标均显著低于对照组(t=2.662~6.924;U=28942.500,均P<0.01),CIAKI的发生率也显著低于对照组(1.36%vs.9.83%,χ^(2)=20.061,P<0.01)。多因素Logistic回归分析表明,复方丹参滴丸对CIAKI有保护作用(OR=0.123,95%CI:0.042~0.360,P<0.01)。结论:复方丹参滴丸对肾功能异常患者PCI后CIAKI的发生有一定的保护作用。