【作者】 陈春；

【导师】 杨天伦；

【作者基本信息】 中南大学 ， 心血管内科， 2008， 硕士

【摘要】 目的:观察丹参多酚酸盐治疗不稳定型心绞痛患者的临床疗效,初步探讨其对血浆TXA₂/PGI₂的影响。方法:我院心内科住院的不稳定型心绞痛患者60例,随机分为常规治疗组（n=30）和丹参多酚酸盐组（n=30）。两组均常规给予肠溶阿司匹林、普伐他汀及美托洛尔等治疗,丹参多酚酸盐组在上述治疗基础上加用丹参多酚酸盐（200mg+5%GS 250ml,静滴,每天一次）;两组疗程均为2周。以健康体检者20例为正常对照组。临床疗效观察心绞痛症状（发作次数、程度、持续时间等）及含服的硝酸甘油量的变化;同时治疗前后各做一次心电图,观察ST段等改变情况。用药前后各采集空腹静脉血5ml,用ELISA法检测血栓素和前列环素的表达。结果:（1）常规治疗组和丹参多酚酸盐组心绞痛症状疗效总有效率分别为63.3%、86.7%（P＜0.05）,丹参多酚酸盐组心绞痛症状的改善明显优于常规治疗组;（2）常规治疗组和丹参多酚酸盐组心电图好转总有效率分别为60.0%、83.3%（P＜0.05）,丹参多酚酸盐组心电图好转优于常规治疗组;（3）常规治疗组和丹参多酚酸盐组所含服的硝酸甘油停减率分别为53.3%、80.0%（P＜0.05）,丹参多酚酸盐组硝酸甘油停减率明显优于常规治疗组;（4）与正常组比较,治疗前常规治疗组和丹参多酚酸盐组血浆TXA₂、TXA₂/PGI₂比值明显升高,PGI₂明显降低（P＜0.05）,而常规治疗组和丹参多酚酸盐组之间无明显差别。（5）常规治疗组和丹参多酚酸盐组治疗后血浆TXA₂、TXA₂/PGI₂比值均较治疗前明显下降,PGI₂均较治疗前显著升高（P＜0.01）;而丹参多酚酸盐组明显优于常规治疗组（P＜0.01）。（6）TXA₂和PGI₂呈显著负相关（P＜0.01）。结论:丹参多酚酸盐能明显改善冠心病心绞痛患者的症状和心电图ST-T改变,其机制可能与丹参多酚酸盐抑制TXA₂分泌、促进PGI₂释放,纠正TXA₂/PGI₂失衡有关。更多还原

【Abstract】 Objectives:To observe the effect of Salvianola on patients of unstable angina pectoris and study the influence of TXA₂ and PGI₂.Methods:The study group was comprised of 60 patients from inpatient wards with unstable angina pectoris,who were randomly divided into routine treatment group（n=30）and Salvianola group（n=30）. The patients of two groups were gave the routine treatment,involving in aspirin and provastatin and betaloc;whereas the patients of Salvianola group receiving the same treatment regimen plus Salvianola（200mg +5%GS250ml,ivgtt,Per day）.The trial period was 14 days.Before and after the 14-day treatment,the clinical symptom was measured and electrocardiogram was performed;Meanwhile,the concentrations of thromboxan、prostacyclin in plasma were detected by ELISA.Results:（1）The symptomatic effective rate of unstable angina pectoris in Salvianola group was 86.7%,which was higher than 63.3%in routine treatment group（P＜0.05）;（2）The total ECG effective rate was 83.3%in Salvianola group,which was higher than 60.0%in routine treatment group（P＜0.05）;（3）The stop-decrease rate of nitroglycerin was 80.0%in Salvianola group,which was higher than 53.3%in routine treatment group（P＜0.05）;（4）Before the treatment,concentrations of TXA₂ and TXA₂/PGI₂ ratio in plasma in patients routine treatment group and Salvianola group were higher than those in normal group respectively, whereas the concentrations of PGI₂ was lower than that in normal group（P＜0.05）.There was no significant difference between routine treatment group and Salvianola group;（5）After the treatment,the concentrations of TXA₂ and TXA₂/PGI₂ ratio in plasma in Salvianola group was significantly lower than those routine treatment group and before treatment,whereas the concentrations of PGI₂ was higher than those routine treatment group and before treatment（P＜0.01）.（6）There were significantly negative correlations between the levels of TXA₂ and PGI₂ in blood serum（P＜0.01）.Conclusions:Salvianola can remarkably improve the symptoms of unstable angina pectoris;Salvianola can inhibit TXA₂ secretion and promote PGI₂ releasing,redress TXA₂/PGI₂ imbalance,this may be a mechanism of Salvianola therapeutic effect on unstable angina pectoris.更多还原