丹参酮ⅡA 磺酸钠联合阿托伐他汀对冠心病患者血清内皮素1、脑钠肽水平的影响

摘要

目的：观察丹参酮ⅡA磺酸钠联合阿托伐他汀对冠心病患者血浆内皮素1（ET-1）、脑钠肽（BNP）水平的影响，探讨丹参酮ⅡA磺酸钠治疗冠心病的可能机制。方法选取冠心病患者160例，同期进行健康体检的正常人100例作为对照。分别采用放射免疫法和酶联免疫吸附实验（ ELISA）测定血浆ET-1、BNP水平。将160例冠心病患者随机分为观察A组和观察B组，每组80例，观察A组在常规治疗基础上给予阿托伐他汀治疗，观察B组在观察A组基础上加用丹参酮ⅡA磺酸钠注射液，疗程为30 d，观察2组治疗前后左心室射血分数（ LVEF）、左心室收缩末期内径（ LVESD）、左心室舒张末期内径（ LVEDD）及血浆ET-1、BNP水平。同时比较2组生活质量改善状况。结果与对照组比较，冠心病患者组血浆ET-1、BNP水平显著升高，差异有统计学意义（ P ＜0 I．05）；且随着心功能分级及冠脉病变严重程度的增加，血浆ET-1、BNP水平逐渐升高，差异有统计学意义（P＜0．05）。血浆ET-1、BNP水平与心功能及冠脉病变严重程度呈正相关（ P ＜0．05）。与治疗前比较，治疗后观察A组和观察B组ET-1、BNP水平显著降低，差异有统计学意义（ P ＜0．05），但观察B组降低程度更明显，差异有统计学意义（ P ＜0．05）。观察B组生活质量改善程度显著优于观察A组，差异有统计学意义（P＜0．05）。结论丹参酮ⅡA磺酸钠联合阿托伐他汀治疗能够有效改善患者心功能，其机制与降低血浆ET-1、BNP水平有关。%Objective To investigate the role of plasma endothelin (ET-1) and brain natriuretic (BNP) in coronary heart diseases (CHD), and to analyze the effects of sodium tanshinone ⅡA sulfonate combined with atorvastatin on the expression levels of ET-1 and BNP.Methods One hundred and sixty patients with CHD who were diagnosed and treated in our hospital were randomly divided into observation group A ( n =80) and observation group B ( n =80),at the same time, 100 healthy subjects were served as control group.The plasma levels of ET-1 and BNP were detected by radioimmunoassay and enzyme-linked immunosorbent assay (ELISA),respectively.The 80 patients in observation group A,on the basis of routine therapy,were treated by atorvastatin,however,the other 80 patients in observation group B,on the basis of observation group A, were treated by sodium tanshinone ⅡA sulfonate injection, with a treatment course of 30 days for both groups.The left ventricular ejection fraction (LVEF), left ventricular internal dimension at end-systolic (LVESD),left ventricular internal dimension at end-diastole ( LVEDD) ,plasma levels of ET-1 and BNP were detected before and after treatment,meanwhile, the improvement status of life quality of patients was compared between two groups.Results The plasma levels of ET-1 and BNP in CHD groups were significantly increased,as compared with those in control group ( P <0.05),moreover, the plasma levels of ET-1 and BNP were gradually increased with the increasing of grading of cardiac function and severe degree of of coronary artery lesions ( P <0.05).The plasma levels of ET-1 and BNP were positively correlated to cardiac function and severe degree of of coronary artery lesions ( P <0.05).As compared with those before treatment, the plasma levels of ET-1 and BNP were significant decreased after treatment in both observation groups ( P <0.05) ,furthermore, the decreasing degree in observation group B was more obvious than that in observation group A ( P <0.05).In addition, the improvement degree of life quality of patients in observation group B was superior to that in observation group A ( P <0.05).Conclusion Sodium tanshinoneⅡA sulfonate combined with atorvastatin can effectively improve cardiac function of patients with CHD, and its action mechanism may be correlated to reducing the plasma levels of ET-1 and BNP.