酒石酸美托洛尔联合丹红注射液对冠心病 U AP 患者心电图及血清 BNP 、 sICAM—1 水平的影响

摘要

目的:探讨酒石酸美托洛尔联合丹红注射液对冠心病不稳定型心绞痛(CHD—UAP)患者的疗效及对血清脑钠肽(BNP) 、可溶性细胞间黏附分子—1 (sICAM—1 )水平的影响.方法:选择 2013年 3月～ 2017年5 月我院CHD—UAP患者104例.患者被随机均分为美托洛尔组(在常规治疗基础上接受美托洛尔)和联合治疗组(在美托洛尔组基础上接受丹红注射液),两组均持续治疗2周.观察比较两组临床及心电图疗效,治疗前、2周后心绞痛发作频率、持续时间、血清BNP和sICAM—1水平,以及不良反应发生情况.结果:治疗2周后,联合治疗组临床治疗总有效率(84. 62% 比63.46%)和心电图总有效率(90.38% 比69. 23%)均显著高于美托洛尔组, P＝0.014 , 0.007 .与治疗前比较,治疗2周后两组心绞痛发作频率和持续时间,血清BNP和sICAM—1水平均显著降低, P均＝0.001 ;且与美托洛尔组比较,治疗2周后联合治疗组心绞痛发作频率[(6.03 ± 0.72)次／周比(2.69 ± 0.54)次／周]和持续时间[ (4.82 ± 0. 51) min／次比(2.65 ± 0.70) min／次] ,血清BNP [ (652.43 ± 97.15) pg／ml比(536. 27 ± 95. 40) pg／ml]和sICAM—1 [ (105.27 ± 29. 14) ng／L比(81.03 ± 26. 43) ng／L]水平降低更显著, P均＝0.001 .两组不良反应发生率比较无显著差异, P＝0.506 .结论:对冠心病不稳定型心绞痛患者予以酒石酸美托洛尔联合丹红注射液治疗,疗效显著,可有效降低血清BNP 、 sICAM—1水平,减少心绞痛发作频率与持续时间,且安全性较高,值得推广.%Objective :To explore therapeutic effect of metoprolol tartrate combined Danhong injection on patients with unstable angina pectoris of coronary heart disease (CHD—UAP) and its influence on serum levels of brain natri—uretic peptide (BNP) and soluble intercellular adhesion molecule—1 (sICAM—1).Methods : A total of 104 CHD—UAP patients treated in our hospital from Mar 2013 to May 2017 were randomly and equally divided into metoprolol group (received metoprolol based on routine treatment ) and combined treatment group (received Danhong injection based on metoprolol group) ,both groups were continuously treated for two weeks .Onset frequency and duration of angina pectoris ,serum BNP and sICAM—1 levels before and two weeks after treatment ,and incidence of adverse reactions were observed and compared between two groups .Results : After two—week ,clinical total effective rate (84. 62%vs.63. 46%) and ECG total effective rate (90.38% vs.69. 23%) of combined treatment group were significantly higher than those of metoprolol group , P＝0. 014 ,0.007. Compared with before treatment ,there were significant reductions in onset frequency and duration of angina pectoris and serum levels of BNP and sICAM—1 after two—week treatment in two groups , P＝0.001 all ;compared with metoprolol group after two—week treatment ,there were sig—nificant reductions in onset frequency [ (6. 03 ± 0.72 ) times／week vs .(2.69 ± 0.54 ) times／week ] and duration [ (4. 82 ± 0.51) min／time vs .(2. 65 ± 0.70) min／time] of angina pectoris ,serum levels of BNP [ (652.43 ± 97. 15) pg／ml vs .(536. 27 ± 95. 40) pg／ml] and sICAM—1 [ (105.27 ± 29.14) ng／L vs.(81.03 ± 26. 43) ng／L] in combined treatment group , P＝0. 001 all.There was no significant difference in incidence rate of adverse reactions between two groups , P＝0.506. Conclusion : Metoprolol tartrate combined Danhong injection possesses significant therapeu—tic effect on CHD—UAP patients .It can effectively reduce serum BNP and sICAM—1 levels ,onset frequency and du—ration of angina pectoris with high safety ,which is worth extending .