丹参多酚酸盐注射液辅助治疗不稳定型心绞痛疗效及对血清炎症因子、代谢组学变化的影响  

Effect of Salvia Miltiorrhiza Injection on Unstable Angina Pectoris, Serum Inflammatory Factors and Metabonomics

作　　者：宋建江 杨应军[1] 苏腾[2] 赵勤旭 Song Jianjiang;Yang Yingjun;Su Teng;Zhao Qinxu(Department of Cardiology, the First People's Hospital of Jiashan, Jiashan(314100), China;Department of Cardiology, Tieling Central Hospital,Tieling (112001), China;Guangxi University of Traditional Chinese Medicine, Nanning(530200), China)

机构地区：[1]浙江省嘉善县第一人民医院心内科,嘉善314100 [2]辽宁省铁岭市中心医院心内科,铁岭112001 [3]广西中医药大学,南宁530200

出　　处：《浙江中西医结合杂志》2017年第12期1026-1031,共6页Zhejiang Journal of Integrated Traditional Chinese and Western Medicine

基　　金：国家自然科学基金(No.816607013)

摘　　要：目的观察丹参多酚酸盐注射液辅助治疗冠心病不稳定型心绞痛(UAP)的作用机制。方法收集73例冠心病不稳定心绞痛(UAP)患者随机分为观察组42例和对照组31例,两组均采用常规治疗,观察组在此基础上静脉滴注丹参多酚酸盐注射液,14天为1个疗程。采用硝酸还原酶比色法检测两组患者治疗前后血清一氧化氮(NO)含量,ELISA法检测内皮素-1(ET-1)、饥饿激素(Ghrelin)、白介素-6(IL-6)、白介素-10(IL-10)及内脂素(Visfatin)水平;采用超高效液相色谱仪与成分分析法分析两组患者治疗前后血清代谢差异物,并用EZinfo 2.0软件进行PCA分析潜在差异生物标记物。结果 (1)与对照组比较,观察组临床症状、心电图总疗效明显高于对照组(临床症状疗效:83.81%比66.74%,P<0.05;心电图疗效:83.33%比54.84%,P<0.05);(2)对照组治疗后较治疗前血清NO、IL-10、Ghrelin表达升高(P<0.05),ET-1、IL-6及Visfatin表达降低(P<0.05);观察组治疗后较对照组治疗后血清NO、Ghrelin、IL-10表达增高[NO:(66.79±8.11)μmol/L比(60.34±4.86)μmol/L,P<0.05;Ghrelin:(23.64±3.25)μg/L比(15.81±1.87)μg/L,P<0.05;IL-10:(174.18±9.95)pg/mL比(166.39±17.21)pg/mL,P<0.05],ET-1、IL-6及Visfatin降低[ET-1:(55.59±6.37)pg/mL比(69.24±9.37)pg/mL,P<0.05;IL-6:(70.81±5.28)pg/mL比(86.39±6.37)pg/mL,P<0.05;Visfatin:(19.68±3.39)μg/mL比(29.71±3.88)μg/mL,P<0.05];(3)对照组治疗前后血清生物标记物无明显变化,观察组治疗后较治疗前鉴定出5种代谢差异物,其中色氨酸、9'-羧基-γ-生育酚含量升高,溶血磷脂、花生四烯酸及胆汁酸含量下降。结论丹参多酚酸盐注射液可从舒张血管、抗氧化、减轻炎症反应等多个方面起到辅助治疗UAP的作用。Objective To investigate the mechanism of intravenous infusion of Salvia miltiorrhiza injection in the treatment of unstable angina pectoris(UAP).Methods Seventy-three patients with UAP were randomly divided into observation group(n=42)and control group(n=31).The patients in the two groups were treated with conventional therapy.The observation group was given intravenous drip of Salvia miltiorrhiza injection on the basis of the experiment.The course of treatment was14days.The ratio of nitrate reductase assay were used to detect serum nitric oxide(NO)content;ELISA method was used to detect endothelin-1(ET-1),Ghrelin,IL-6and IL-10expression of peptide and lipid Visfatin;Ultra high performance liquid chromatography(HPLC)and component analysis were used to analyze the differences in serum metabolites between the two groups,and the potential biomarkers were analyzed by EZinfo using principle components analysis.Results Compared with control group,observation group had higher total efficiency in the clinical symptoms and ECG(the efficiency of clinical symptoms:83.87%vs66.74%,P<0.05;the efficiency of cECG:88.33%vs54.84%,P<0.05).After treatment,the serum NO,Ghrelin,IL-10expression were increased(P<0.05),ET-1,IL-6and Visfatin expression were decreased in control group(P<0.05);compared with control group,the observation group after treatment had higher expressions of serum NO,IL-10,and Ghrelin[NO:(66.79±8.11)滋mol/L vs(60.34±4.86)umol/L,P<0.05;Ghrelin:(23.64±3.25)ug/L vs(15.81±1.87)ug/L,P<0.05;IL-10:(174.18±9.95)pg/mL vs(166.39±17.21)pg/mL,P<0.05]and lower levels of ET-1IL-6and Visfatin[ET-1:(55.59±6.37)pg/mL vs(69.24±9.37)pg/mL,P<0.05;IL-6:(70.81±5.28)pg/mL vs(88.39±6.37)pg/mL,P<0.05;Visfatin:(19.68±3.39)ug/mL vs(29.71±3.88)ug/mL,P<0.05].After treatment in observation group,tryptophan and9'-carboxy-r-chromanol were increased,lysophospholipids,arachidonic acid and bile acid content were decreased,while the metabolites in control group remained the same as those before treatment.Conclusion Salvia miltiorrhiza i

关 键 词：冠心病 丹参多酚酸盐注射液 炎症因子 代谢组学 内皮素-1 一氧化氮 

分 类 号：R541.4[医药卫生—心血管疾病]