复方丹参滴丸联合阿托伐他汀治疗冠心病并高脂血症的疗效及对血清 TRAIL 的影响

摘要

Objective :To explore therapeutic effect of compound Danshen dripping pills combined atorvastatin on cor-onary heart disease (CHD) complicated hyperlipidemia and its influence on serum level of tumor necrosis factor-re-lated apoptosis inducing ligand (TRAIL).Methods : A total of 109 CHD patients with hyperlipidemia treated in our department of cardiology were collected ,randomly divided into atorvastatin group (n＝57) and combined treatment group (n＝ 52 ,received atorvastatin combined compound Danshen dripping pills ) ,both groups were continuously treated for three months .Cardiac function ,levels of blood lipids ,serum tumor necrosis factor (TNF)-α ,TRAIL and quality of life (QOL ) were measured and compared between two groups before and after treatment .Results :Compared with before treatment ,there were significant improvements in cardiac function and blood lipid levels , and significant reductions in serum levels of TNF-α and TRAIL in two groups after treatment , P＝0-001 all ;com-pared with atorvastatin group after treatment ,there were significant rise in cardiac output [ (4-1 ± 0-8) L／min vs. (4-9 ± 0-6) L／min] ,cardiac index [ (3-9 ± 0-6) L·min-1 ·m-2 vs.(4-2 ± 0-7) L·min-1 ·m-2 ] ,LVEF [ (52-4 ± 1-6)% vs.(59-6 ± 1-5)%] ,serum HDL-C [ (1-5 ± 0-4) mmol／L vs.(1-9 ± 0-5) mmol／L] and QOL [ (6-2 ± 0-8) scores vs .(7-1 ± 1-1) scores] ,and significant reductions in LVEDd [ (5-4 ± 0-6) cm vs.(5-0 ± 0-7) cm] ,serum levels of TC [ (4-1 ± 0-7) mmol／L vs.(3-7 ± 0-9) mmol／L] ,TG [ (1-4 ± 0-6) mmol／L vs.(1-1 ± 0-5) mmol／L] , LDL-C [ (2-9 ± 0-8) mmol／L vs .(2-4 ± 0-8) mmol／L] ,TNF-α [ (52-1 ± 12-6) ng／L vs.(41-3 ± 14-2) ng／L] and TRAIL [ (44-7 ± 24-1) pg／ml vs.(34-1 ± 26-6) pg／ml] in combined treatment group , P＜0-05 or ＜ 0-01- Conclusion : Compound Danshen dripping pills combined atorvastatin can significantly improve heart function ,re-duce blood lipid levels and improve quality of life in CHD patients with hyperlipidemia .%目的:探讨复方丹参滴丸联合阿托伐他汀治疗冠心病并高脂血症的疗效及对血清肿瘤坏死因子相关凋亡诱导配体(TRAIL)的影响.方法:收集我院的冠心病合并高脂血症患者109例.随机分为阿托伐他汀组(57例)和联合治疗组(52例,阿托伐他汀联合复方丹参滴丸治疗) ,疗程3个月,检测治疗前后的心功能、血脂、血清肿瘤坏死因子(TNF-α) 、 TRAIL水平及生活质量.结果:与治疗前比较,治疗后两组心功能和血脂水平均有显著改善,血清TNF-α和TRAIL水平均显著降低(P均＝0-001) ;且与阿托伐他汀组比较,联合治疗组治疗后心排血量[ (4-1±0-8) L／min比(4-9±0-6) L／min]、心脏指数[ (3-9±0-6)L·min-1 ·m-2比(4-2±0-7)L·min-1 · m-2 ] 、左室射血分数[ (52-4 ± 1-6)% 比(59-6 ± 1-5)%] 、血清高密度脂蛋白-胆固醇[ (1-5 ± 0-4) mmol／L比(1-9 ± 0-5) mmol／L]水平及生活质量[ (6-2 ± 0-8 )分比(7-1 ± 1-1 )分]均显著提高,左室舒张末期内径[ (5-4 ± 0-6) cm比(5-0 ± 0-7) cm] 、血清总胆固醇[ (4-1 ± 0-7) mmol／L比(3-7 ± 0-9) mmol／L] 、甘油三酯[ (1-4 ± 0-6) mmol／L比(1-1 ± 0-5 ) mmol／L ] 、低密度脂蛋白-胆固醇[ (2-9 ± 0-8 ) mmol／L比(2-4 ± 0-8 ) mmol／L] 、 TNF-α [ (52-1 ± 12-6) ng／L比(41-3 ± 14-2) ng／L]和 TRAIL [ (44-7 ± 24-1) pg／ml比(34-1 ± 26-6) pg／ml]水平显著降低( P＜0-05或＜0-01) .结论:复方丹参滴丸联合阿伐他汀治疗冠心病并高脂血症患者,可显著改善心功能、降低血脂水平,提高生活质量.