丹参酮ⅡA磺酸钠联合尼可地尔治疗冠心病稳定性心绞痛疗效及对心功能改善研究  

Efficacy of sodium tanshinoneⅡA sulfonate combined with nicorandil for stable angina pectoris and cardiac function in patients with CHD

作　　者：周付娇 吕勇[1] 张静[2] Zhou Fujiao;LüYong;Zhang Jing(Department of Cardiac Surgery,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,HenanProvince,China)

机构地区：[1]南阳医学高等专科学校第一附属医院心脏外科,473000 [2]南阳医学高等专科学校第一附属医院检验科,473000

出　　处：《中华老年心脑血管病杂志》2024年第11期1301-1305,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的 分析丹参酮ⅡA磺酸钠(sodium tanshinone sulphonate, STS)联合尼可地尔治疗冠心病(coronary heart disease, CHD)稳定性心绞痛患者的临床疗效,并探究对患者氧化应激、血清肌红蛋白(myoglobin, MYO)、肌钙蛋白T(cardiac troponin T,cTnT)水平的影响。方法 选取2022年3月至2024年3月南阳医学高等专科学校第一附属医院心脏外科收治的CHD稳定性心绞痛患者164例,使用简单随机数表法分为对照组82例(尼可地尔治疗)和观察组82例(STS联合尼可地尔治疗)。比较2组疗效、治疗前后氧化应激指标[超氧化物歧化酶(superoxide dismutase, SOD)、脂质过氧化产物(lipid peroxide, LPO)、丙二醛(malondialdehyde, MDA)、谷胱甘肽过氧化物酶(glutathione peroxidase, GSH-PX)]、血清MYO、cTnT水平、心功能指标[心排血量(cardiac output, CO)、左心室射血分数(left ventricular ejection fraction, LVEF)]、心绞痛症状、生活质量及运动耐力,并记录不良反应。结果 观察组总有效率显著高于对照组(95.12%vs 82.93%,P<0.05);观察组治疗后SOD、GSH-Px水平显著高于对照组,LPO、MDA水平显著低于对照组(P<0.01);观察组治疗后血清Myo、cTnT水平显著低于对照组(P<0.01);观察组治疗后CO、LVEF显著高于对照组[(5.74±0.59)L/min vs(5.38±0.46)L/min,P<0.01;(55.06±4.27)%vs(49.14±3.85)%,P<0.01];观察组治疗后加拿大心血管病学会心绞痛分级显著低于对照组,西雅图心绞痛量表评分、六分钟步行试验距离显著高于对照组(P<0.01);2组不良反应发生率比较无统计学差异(P>0.05)。结论 STS联合尼可地尔治疗CHD稳定性心绞痛有助于提升疗效,减轻氧化应激,保护患者心功能,安全性良好。Objective To investigate the clinical efficacy of sodium tanshinoneⅡA sulfonate(STS)combined with nicorandil in the treatment of coronary heart disease(CHD)patients with stable angina pectoris,and explore the influence on oxidative stress,serum myoglobin(Myo)and cardiac troponin T(cTnT)levels.Methods A total of 164 CHD patients with stable angina pectoris admitted in our hospital from March 2022 to March 2024 were recruited and randomly divided into control group(82 cases,nicorandil treatment)and observation group(82 cases,STS combined with nicorandil treatment).The efficacy,oxidative stress indicators[superoxide dismutase(SOD),lipid peroxide(LPO),malondialdehyde(MDA),glutathione peroxidase(GSH-Px)],serum Myo and cTnT levels,cardiac function indicators[cardiac output(CO),left ventricular ejection fraction(LVEF)],angina pectoris symptoms,quality of life and exercise tolerance were compared before and after treatment and between the two groups,and adverse reactions were recorded.Results The total effective rate was significantly higher in observation group than the control group(95.12%vs 82.93%,P<0.05).After treatment,the observation group obtained significantly higher SOD and GSH-Px levels,while lower LPO and MDA levels and serum Myo and cTnT levels when compared with the control group(P<0.01).Obviously higher CO(5.74±0.59 L/min vs 5.38±0.46 L/min,P<0.01)and LVEF[(55.06±4.27)%vs(49.14±3.85)%,P<0.01]values in the observation group were observed after treatment than those in the control group.After treatment,the observation group had notably lower Canadian Cardiovascular Society angina pectoris grade and higher Seattle Angina Questionnaire score and increased results of 6-minute walking test when compared to the control group(P<0.01).But there was no statistical difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion STS combined with nicorandil is helpful to improve the efficacy,reduces the oxidative stress,and protects the cardiac function in CHD patients with stable angina

关 键 词：冠心病 心绞痛 丹参酮ⅡA 尼可地尔 

分 类 号：R541.4[医药卫生—心血管疾病]