参芍胶囊联合贝尼地平对冠心病心绞痛患者血管内皮功能、心肌损伤以及TLR4/NF-κB信号通路的影响  

Effect of Shenshao Capsule combined with benidipine on vascular endothelial function,myocardial injury and TLR4/NF-κB signaling pathway in patients with angina pectoris of coronary heart disease

作　　者：刘永华 王文静 姚艳影 张金龙 陈俊男 LIU Yonghua;WANG Wenjing;YAO Yanying;ZHANG Jinlong;CHEN Junnan(Department of Cardiovascular Medicine,Chengde Municipal Central Hospital,Chengde,Hebei 067000,China)

机构地区：[1]河北省承德市中心医院心血管内科,河北承德067000

出　　处：《检验医学与临床》2025年第9期1257-1261,共5页Laboratory Medicine and Clinic

基　　金：河北省医学科学研究课题(20232126)。

摘　　要：目的探讨参芍胶囊联合贝尼地平对冠心病心绞痛患者血管内皮功能、心肌损伤以及Toll样受体4(TLR4)/核因子-κB(NF-κB)信号通路的影响。方法选择2022年1月至2023年12月该院收治的冠心病心绞痛患者112例作为研究对象,按照随机数字表法分为对照组(心绞痛常规治疗并服用贝尼地平,n=56)和研究组(在对照组基础上加用参芍胶囊,n=56)。观察2组临床疗效、心绞痛发作频率、心绞痛发作持续时间、缺血总负荷、血管内皮功能指标水平、心肌损伤指标水平、不良反应发生情况,以及外周血TLR4、NF-κB mRNA水平。结果研究组总有效率为94.64%,明显高于对照组的82.14%,差异有统计学意义(P<0.05)。治疗后2组心绞痛发作频率、缺血总负荷、心绞痛持续时间均较入院时明显减少(P<0.05),且治疗后研究组心绞痛持续时间、缺血总负荷、心绞痛发作频率均少于对照组(P<0.05)。治疗后2组血清肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白T(cTnT)、心肌肌钙蛋白I(cTnI)水平均较入院时降低(P<0.05),且治疗后研究组血清CK、CK-MB、cTnT、cTnI水平均低于对照组(P<0.05)。治疗后2组血清内皮素-1(ET-1)、血栓素2(TXB2)水平均较入院时降低(P<0.05),一氧化氮(NO)水平较入院时升高(P<0.05);治疗后研究组血清ET-1、TXB2水平均低于对照组(P<0.05),NO水平高于对照组(P<0.05)。治疗后2组外周血单核细胞TLR4、NF-κB mRNA水平均较入院时降低(P<0.05),且治疗后研究组外周血单核细胞TLR4、NF-κB mRNA水平均低于对照组(P<0.05)。治疗期间研究组不良反应总发生率为10.71%,对照组不良反应总发生率为7.14%,2组不良反应总发生率比较,差异无统计学意义(P>0.05)。结论参芍胶囊联合贝尼地平治疗冠心病心绞痛疗效显著,可改善患者血管内皮功能,减轻心肌损伤,并且能有效调节TLR4/NF-κB信号通路。Objective To explore the effects of Shenshao Capsule combined with benidipine on the vascular endothelial function,myocardial injury and Toll-like receptor 4(TLR4)/nuclear factor-κB(NF-κB)signaling pathway in the patients with angina pectoris of coronary heart disease.Methods A total of 112 patients with angina pectoris of coronary heart disease admitted and treated in this hospital from January 2022 to December 2023 were selected as the research subjects and divided into the control group(conventional treatment of angina pectoris and orally taking benidipine,n=56)and study group(adding Shenshao Capsule on the basis of the control group,n=56)according to the random number table method.The clinical efficacy,frequency of angina pectoris,total ischemic load and duration of angina pectoris in both groups were significantly reduced compared with those at admission,levels of vascular endothelial function indicators,levels of myocardial injury indicators,occurrence of adverse reactions and levels of peripheral blood TLR4 and NF-κB mRNA in the two groups were observed.Results The total effective rate of the study group was 94.64%,which was significantly higher than 82.14%of the control group,and the difference was statistically significant(P<0.05).After treatment,the attack frequency of angina pectoris,total ischemic load and duration of angina pectoris in both groups were significantly reduced compared with those at admission(P<0.05),moreover after treatment,the duration of each angina pectoris attack,total ischemic burden and frequency of angina pectoris attacks in the study group were all less than those in the control group(P<0.05).The levels of serum creatine kinase(CK),creatine kinase MB isoenzyme(CK-MB),cardiac troponin T(cTnT)and cardiac troponin I(cTnI)after treatment in the two groups were lower than those at admission(P<0.05),moreover the levels of serum CK,CK-MB,cTnT and cTnI after treatment in the study group were lower than those in the control group(P<0.05).The levels of serum endothelin-1(ET-1)and thro

关 键 词：参芍胶囊 贝尼地平 冠心病 心绞痛 Toll样受体4 核因子-κB 心肌损伤 血管内皮功能 

分 类 号：R259[医药卫生—中西医结合] R446.11[医药卫生—中医内科学]