冠心丹参滴丸对老年冠状动脉粥样硬化性心脏病不稳定型心绞痛患者血小板活化功能及血清MMP-9、sICAM-1及tPAI-1水平的影响  

Influence of Guanxin Danshen dripping pill on platelet activation and serum levels of MMP-9,sICAM-1,tPAI-1 in elderly patients with unstable angina pectoris of coronary atherosclerotic heart disease

作　　者：陈媛[1] 林尤斌[1] 吴清柳[2] 桂树虹[3] CHEN Yuan;LIN You-Bin;WU Qing-liu;GUI Shu-hong(Office of Disease Prevention and Control,Division of Prevention and Health Care,Hainan People's Hospital,Haikou 570311,Hainan Province,China;Department of Internal Medicine-Cardiovascular,Hainan General Hospital,Haikou 570311,Hainan Province,China;Department of Traditional Chinese Medicine,Hainan General Hospital,Haikou 570311,Hainan Province,China)

机构地区：[1]海南省人民医院预防保健处疾病预防控制办公室,海南海口570311 [2]海南省人民医院心血管内科,海南海口570311 [3]海南省人民医院中医科,海南海口570311

出　　处：《世界临床药物》2020年第2期111-117,共7页World Clinical Drug

摘　　要：目的探讨冠心丹参滴丸治疗老年冠状动脉粥样硬化性心脏病不稳定型心绞痛患者的临床疗效及对其血小板活化功能、血清金属基质蛋白酶(serum metalloproteinase,MMP)-9、可溶性细胞间黏附分子(soluble intercellular adhesion moleculess,sICAM)-1及1型组织纤溶酶原激活物抑制剂(tissue plasminogen activator inhibitor-1,tPAI-1)水平的影响。方法选取2018年1月至2019年5月海南省人民医院心内科240例老年冠心病不稳定型心绞痛患者,将其随机分为观察组及对照组,每组各120例。对照组接受西医综合治疗,观察组在此基础上联合冠心丹参滴丸治疗,两组疗程均为4周。比较两组临床疗效,用药前后测定外周血血小板微粒及其表面膜蛋白(CD40L、CD62p、CD63、PAC-1),同时测定血清MMP-9、sICAM-1及tPAI-1水平。结果观察组及对照组分别有118例和116例完成研究。观察组心绞痛症状疗效及中医证候疗效的总有效率分别为88.14%和94.07%,分别高于对照组的75.86%和82.76%(P<0.05)。用药4周后,两组的全球急性冠脉事件评分和中医证候评分均明显下降,且观察组的下降幅度较对照组更明显,差异有统计学意义(P<0.05)。用药4周后,两组外周血血小板微粒及其膜蛋白(CD40L、CD62p、CD63、PAC-1)、血清MMP-9、sICAM-1及tPAI-1水平较治疗前均降低,且观察组降低幅度较对照组更明显,差异均有统计学意义(P<0.05)。结论冠心丹参滴丸联合西医治疗老年冠心病不稳定型心绞痛患者可提高临床疗效,其机制可能与抑制血小板活化及MMP-9、sICAM-1、tPAI-1表达有关。Objective To investigate the clinical effect of Guanxin Danshen dropping pill on the elderly patients with unstable angina pectoris and its platelet activation function,serum metalloproteinase(MMP)-9,soluble intercellular adhesion molecule(sICAM)-1,tissue plasminogen activator inhibitor type 1(tPAI-1).Methods A total of 240 elderly patients with unstable coronary heart disease and unstable angina pectoris were selected from January 2018 to May 2019 in the Department of cardiology,Hainan provincial people's hospital and randomly divided into observation group and control group,120 cases each.the control group was treated with western medicine and the observation group was treated with Guanxin Danshen dropping pill on this basis.The course of treatment in both groups was 4 weeks.The clinical efficacy of the two groups was compared.Platelet microparticles and their surface protein(CD40L,CD62p,CD63,PAC-1)were measured before and after treatment,and the levels of serum MMP-9,sICAM-1 and tPAI-1 were measured.Results A total of 118 cases in the observation group and 116 cases in the control group completed the study.The total effective rates of angina symptoms and traditional Chinese medicine syndromes in the observation group were 88.14%and 94.07%,respectively,higher than 75.86%and 82.76%in the control group(P<0.05).After 4 weeks of treatment,global registration of acute coronary events score and traditional Chinese medicine syndrome score of the two groups were significantly reduced,and the decline of the observation group was more significant than that of the control group,the difference was statistically significant(P<0.05).After 4 weeks of treatment,the levels of platelet microparticle and membrane protein(CD40L,CD62p,CD63,PAC-1),serum MMP-9,sICAM-1 and tPAI-1 in the two groups were lower than those before treatment,and the decreased range in the observation group was more significant than that in the control group,the difference was statistically significant(P<0.05).Conclusion Guanxin Danshen dropping pill combine

关 键 词：冠状动脉粥样硬化性心脏病 不稳定型心绞痛 冠心丹参滴丸 血小板活化功能 

分 类 号：R762[医药卫生—耳鼻咽喉科] R979.14[医药卫生—临床医学]