前列地尔联合丹参多酚酸盐治疗不稳定型心绞痛的疗效及对内皮功能的影响

摘要

Objective To investigate the clinical efficacy of alprostadil combined with salvianolate in treatment of unstable angina pectoris (UAP)and the effects on serum levels of nitric oxide(NO)and endothelin(ET). Methods A total of 120 patients were randomly divided into group A,B,and C,with 40 patients in each group. Based on conventional therapies,the group A used Alprostadil Injection additionally,the group B used Salvianolate Injection additionally,and the group C used both additionally;for 2 weeks for all groups. The attack conditions of angina pectoris and the changes in ECG and serum levels of NO and ET in the patients before and after the treatments were observed. Results After 2 weeks of treatment,the clinical overall response rates of the group A,B,and C were 75.00%,72.50%,and 90.00%,respectively,and the ECG overall response rates of the group A,B,and C were 70.00%,67.50%,and 87.50%,respectively. The group A and the group B had similar overall response rates,and the differences were statistically insignificant(P>0.05);while the group C had significantly higher overall response rate than both the group A and B(P<0.05). Before the treatments,the three groups had similar serum levels of NO and ET,and the differences were statistically insignificant(P>0.05);after 2 weeks of treatment,the three groups had significantly decreased serum ET level and significantly increased serum NO level when compared with those before the treatments,but the group C had significantly greater improving extents than both the group A and B(all P<0.05). Conclusion Alprostadil combined with salvianolate in treatment of UAP can significantly improve vascular endothelium function,improve the blood circulation of coronary artery,and elevate the clinical efficacy.%目的：探讨前列地尔联合丹参多酚酸盐治疗不稳定型心绞痛（UAP）的临床疗效，以及对血清一氧化氮（NO）及内皮素（ET）水平的影响。方法 UAP患者120例，采用随机数字表法分为A组、B组和C组各40例，A组在常规治疗的基础上加用前列地尔注射液，B组加用注射液丹参多酚酸盐，C组二者联合，疗程均为2周，观察患者治疗前后心绞痛发作情况、心电图及血清NO、ET水平变化。结果治疗2周后，A组临床总有效率75.00%、心电图总有效率70.00%；B组临床总有效率72.50%、心电图总有效率67.50%；C组临床总有效率90.00%、心电图总有效率87.50%；A组与B组总有效率均相似，差异无统计学意义（P>0.05）；C组总有效率均明显高于A组及B组，差异有统计学意义（P<0.05）。治疗前，三组患者血清ET及NO水平相似，差异无统计学意义（P>0.05）；治疗2周后，三组患者血清ET水平较本组治疗前均下降，NO水平较本组治疗前均上升，但C组改变幅度明显大于A组及B组，差异有统计学意义（P<0.05）。结论前列地尔联合丹参多酚酸盐治疗UAP，可以显著改善血管内皮功能，改善冠状动脉血液循环，提高临床治疗效果。