丹参酮ⅡA磺酸钠联合厄贝沙坦治疗不稳定心绞痛合并慢性心力衰竭疗效及对氧化应激水平的影响

摘要

目的 探讨丹参酮ⅡA磺酸钠联合厄贝沙坦治疗不稳定性心绞痛(UAP)合并慢性心力衰竭(CHF)临床疗效及其对患者氧化应激水平的影响.方法2016年1月至2017年2月,收集乌鲁木齐市中医医院心血管内科116例符合纳入标准的UAP合并CHF患者作为研究对象,回顾性分析其临床资料,按照治疗方案分为对照组58例和观察组58例.常规治疗基础上对照组接受厄贝沙坦治疗,观察组在对照组基础上接受联合丹参酮ⅡA磺酸钠治疗,疗程4周.治疗后比较两组患者UAP临床疗效、CHF临床疗效、心功能、氧化应激水平及不良反应.结果 经过治疗,观察组和对照组患者在UAP方面的治疗总有效率分别为94.8%和81.0%,在CHF方面的治疗总有效率分别为96.6%和82.8%,差异均有统计学意义(P<0.05);心功能方面,观察组和对照组患者治疗后左室射血分数(LVEF)[(50.1±6.3)% vs(46.4±5.1)%]、左室舒张末期内径(LVEDD)[(51.0±3.8)mm vs(53.2±4.2)mm]、左室收缩末期内径(LVESD)[(42.1±3.3)mm vs(43.4±3.6)mm]比较差异均有统计学意义(P<0.05);治疗后,观察组和对照组患者的丙二醛(MDA)水平[(4.18±0.5)μmol/L vs(5.87±0.64)μmol/L]和超氧化物歧化酶(SOD)水平[(90.35±9.45)μU/L vs (81.48±8.23)μU/L]比较差异均有统计学意义(P<0.05);治疗期间,两组患者均无严重不良反应发生,对照组和观察组不良反应发生率分别为12.1%和17.2%,差异无统计学意义(P>0.05).结论 丹参酮ⅡA磺酸钠联合厄贝沙坦是UAP合并CHF的有效治疗方案,其能够有效改善患者心功能,减轻氧化应激,且不增加不良反应发生率,临床上值得应用.%Objective To investigate the curative efficacy of sodium tanshinoneⅡA sulfonate(STS)in combina-tion with irbesarta in patients of unstable angina pectoris(UAP)complicated with chronic heart failure(CHF)and its ef-fects on levels of oxidative stress.Methods A total of 116 cases of patients with UAP complicated with CHF meeting the inclusion criteria,who admitted to Department of Cardiology in Urumqi Hospital of Traditional Chinese Medicine from January 2016 to February 2017,were collected as research objects.Their clinical materials were retrospectively analyzed, and the patients were divided into the control group (n=58) and the observation group (n=58) according to therapeutic schemes.Besides conventional treatments,the control group was treated with irbesarta,while the observation group was treated with STS in combination with irbesarta.After the treatment for 4 weeks,the curative efficacy of UAP,CHF,cardi-ac function,levels of oxidative stress,and adverse reactions were compared between the two groups.Results After the treatment,the total therapeutic efficacy rates of UAP were respectively 94.8% and 81.0% in the observation group and the control group versus corresponding 96.6% and 82.8% for CHF in the two groups(both P<0.05).As to cardiac func-tion after the treatment, there were statistically significant differences in the level of left ventricular ejection fraction (LVEF)(50.1±6.3)% vs(46.4±5.1)%,left ventricular end diastolic diameter(LVEDD)(51.0±3.8)mm vs(53.2±4.2)mm, left ventricular end systolic diameter(LVESD)(42.1±3.3)mm vs(43.4±3.6)mm between the observation group and the control group (all P<0.05).After the treatment, the level of malonaldehyde (MDA) (4.18±0.5) μmol/L vs (5.87± 0.64)μmol/L,and level of superoxide dismutase(SOD)(90.35±9.45)μU/L vs(81.48±8.23)μU/L between the observa-tion group and the control group were statistically significantly different(both P<0.05).During the treatment,there's no case of severe adverse reaction.And the incidences of adverse reactions in the control group and the observation group were 12.1% and 17.2% respectively(P>0.05).Conclusion STS in combination with irbesarta is an effective therapeu-tic scheme for patients of UAP complicated with CHF.It can effectively improve cardiac function and alleviate oxidative stress with not increasing the incidence of adverse reactions.