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[摘要]
目的 探讨丹红注射液联合硝苯地平治疗冠心病无症状性心肌缺血的临床疗效。方法 选取2014年1月-2016年12月在新疆生产建设兵团第九师医院进行治疗的70例冠心病无症状性心肌缺血患者为研究对象,依据用药差别分成对照组(35例)和治疗组(35例)。对照组患者口服硝苯地平片,10 mg/次,3次/d。治疗组在对照组基础上静脉滴注丹红注射液,20 mL加入5%葡萄糖溶液250 mL,1次/d。两组均治疗14 d。评价两组患者临床疗效,同时比较治疗前后两组患者24 h心电图、心率(HR)、心肌耗氧量指数(RPP)和血管内皮功能变化。结果 治疗后,对照组和治疗组总有效率分别为71.43%和91.43%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者ST段压低幅度、压低次数和持续时间以及HR和RPP均显著降低,同组比较差异具有统计学意义(P<0.05);且治疗组比对照组降低的更明显,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清可溶性细胞黏附因子-1(sICAM-1)、可溶性血管细胞黏附分子-1(sVCAM-1)水平显著降低,血管内皮生长因子(VEGF)和NO水平显著增高,同组比较差异具有统计学意义(P<0.05);且治疗组患者血管内皮功能因子水平明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论 丹红注射液联合硝苯地平治疗冠心病无症状性心肌缺血可有效降低心肌耗氧量,改善血管内皮功能,具有一定的临床推广应用价值。
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[Abstract]
Objective To investigate the clinical efficacy of Danhong Injection combined with nifedipine in treatment of silent myocardial ischemia of coronary heart disease. Methods Patients (70 cases) with silent myocardial ischemia of coronary heart disease in the Ninth Divisions' Hospital of Xinjiang Production and Construction Corps from January 2014 to December 2016 were divided into control (35 cases) and treatment (35 cases) groups according to different treatments. Patients in the control group were po administered with Nifedipine Tablets, 10 mg/time, three times daily. Patients in the treatment group were iv administered with Danhong Injection on the basis of the control group, 20 mL added into 5% glucose injection 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacy was evaluated, and the change of 24 h ECG, HR, RPP, and vascular endothelial function in two groups before and after treatment was compared. Results After treatment, the clinical efficacy in the control and treatment groups were 71.43% and 91.43%, respectively, and there were differences between two groups (P<0.05). After treatment, the HR and RPP, and depression, depression times and depression duration of ST-segment in two groups were significantly decreased, and the difference was statistically significant in the same group (P<0.05). And these indexes in the treatment group were obviously lower than those in the control group, with significant difference between two groups (P<0.05). After treatment, the serum sICAM-1 and sVCAM-1 level in two groups was significantly decreased, but VEGF and NO level were significantly increased, and there were differences in the same group (P<0.05). And the vascular endothelial function in the treatment group was significantly better than that in the control group, with significant difference between two groups (P<0.05). Conclusion Danhong Injection combined with nifedipine in treatment of silent myocardial ischemia of coronary heart disease can effectively reduce myocardial oxygen consumption and improve vascular endothelial function, which has a certain clinical application value.
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