丹参多酚酸联合曲美他嗪治疗冠心病心绞痛疗效及其影响因素分析  

Analysis of the therapeutic effect and influencing factors of salvianolic acid combined with trimetazidine in the treatment of angina pectoris in coronary heart disease

作　　者：刘昕[1] 朱兵 叶加虎 刘岩[1] 王芳[1] LIU Xin;ZHU Bing;YE Jiahu;LIU Yan;WANG Fang(North Beijing Medical Area,Chinese PLA General Hospital,Beijing 100091,China;The Second Medical Center,Chinese PLA General Hospital,Beijing 100039,China)

机构地区：[1]中国人民解放军总医院京北医疗区,北京100091 [2]中国人民解放军总医院第二医学中心,北京100039

出　　处：《中南医学科学杂志》2024年第5期853-856,共4页Medical Science Journal of Central South China

摘　　要：目的 探讨丹参多酚酸联合曲美他嗪治疗冠心病(CHD)心绞痛疗效及其影响因素。方法 选取CHD心绞痛患者184例,随机均分为对照组(曲美他嗪治疗)和观察组(曲美他嗪+丹参多酚酸治疗)。比较两组治疗总有效率、心绞痛发作频次和持续时间、血脂代谢标志物[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDLC)和高密度脂蛋白胆固醇(HDLC)]、血管损伤因子[内皮素-1(ET-1)、内皮细胞特异性分子-1(ESM-1)、一氧化氮(NO)]、不良反应发生率。分析心绞痛持续时间与其他指标的相关性,以及疗效的影响因素。结果 观察组治疗总有效率高于对照组(P<0.05)。与治疗前比较,治疗后两组心绞痛发作频次和持续时间减少,TC、TG、LDLC、ET-1、ESM-1水平均降低,HDLC、NO水平升高,且观察组较对照组改善更明显(P<0.05)。治疗后心绞痛持续时间与ET-1、ESM-1呈正相关,与HDLC呈负相关(P<0.001)。ESM-1、ET-1、HDLC均为CHD心绞痛患者疗效的影响因素(P<0.05)。结论 丹参多酚酸联合曲美他嗪治疗CHD心绞痛疗效确切,改善血脂代谢标志物和血管损伤因子水平可提高其疗效。Aim To explore the efficacy and influencing factors of salvianolic acid combined with trimetazidine in the treatment of angina pectoris in coronary heart disease(CHD).Methods A total of 184 patients with angina pectoris of CHD were enrolled and randomly divided into control group(trimetazidine) and observation group(salvianolic acid combined with trimetazidine),with 92 cases in each group.The total response rate of treatment,frequency and duration of angina onset,blood lipid metabolism markers [total cholesterol(TC),triacylglycerol(TG),low density lipoprotein cholesterol(LDLC),high density lipoprotein cholesterol(HDLC)],vascular injury factors [endothelin-1(ET-1),endothelial cell specific molecule-1(ESM-1),nitric oxide(NO)] and incidence of adverse reactions were compared between the two groups.The correlation between angina duration and the other indexes,as well as the influencing factors of curative effect were analyzed.Results The total response rate of treatment in observation group was higher than that in control group(P<0.05).Compared with the indexes before treatment,after treatment,frequency and duration of angina onset,levels of TC,TG,LDLC,ET-1 and ESM-1 were decreased,while HDLC and NO were increased in both groups,and improvement of the above indexes was more significant in observation group than in control group(P<0.05).After treatment,duration of angina pectoris was positively correlated with ET-1 and ESM-1,while negatively correlated with HDLC(P<0.001).ESM-1,ET-1 and HDLC were influencing factors of curative effects in patients with angina pectoris of CHD(P<0.05).Conclusion The curative effects of salvianolic acid combined with trimetazidine is significant in angina pectoris of CHD,improved the levels of blood lipid metabolism markers and vascular injury factors can enhance its therapeutic efficacy.

关 键 词：冠心病心绞痛 丹参多酚酸 曲美他嗪 血脂代谢 血管损伤因子 

分 类 号：R541.4[医药卫生—心血管疾病]