中国中西医结合急救杂志
中國中西醫結閤急救雜誌
중국중서의결합급구잡지
INTEGRATED TRADITIONAL CHINESE AND WESTERN MEDICINE IN PRACTICE OF CRITICAL CARE MEDICINE
2012年
6期
336-339
,共4页
陈永斌%李何鹏%蔡志玲%李若林
陳永斌%李何鵬%蔡誌玲%李若林
진영빈%리하붕%채지령%리약림
通心络%不稳定型心绞痛%基质金属蛋白酶
通心絡%不穩定型心絞痛%基質金屬蛋白酶
통심락%불은정형심교통%기질금속단백매
Tongxinluo%Unstable angina pectoris%Matrix metalloproteinase
目的观察通心络胶囊对不稳定型心绞痛(UAP)患者血浆基质金属蛋白酶-2/9(MMP-2/9)水平的影响,初步探讨其治疗 UAP 的可能作用机制.方法采用前瞻性研究方法.将2010年2月至2011年6月本院收治的110例 UAP 患者按随机数字表法分为通心络组(58例)和常规组(52例).常规组给予阿司匹林+辛伐他汀+硝酸酯类;通心络组在常规组药物治疗基础上加用通心络胶囊3粒(0.26 g/粒),每日3次.同期选择100例年龄匹配的本院健康查体者作为健康对照.采用酶联免疫吸附试验(ELISA)测定患者治疗前及治疗1、2、3个月后的 MMP-2/9浓度.结果 UAP 患者 MMP-2/9(μg/L)水平均明显高于健康对照组(MMP-2:448.09±11.90比215.56±14.74,MMP-9:624.94±12.12比384.41±21.74,均P<0.01).通心络组与常规组治疗前 MMP-2/9浓度相近(MMP-2:450.32±11.20比445.96±12.26,MMP-9:625.92±13.17比623.99±11.07,均P>0.05);随治疗时间延长,两组治疗后 MMP-2/9水平均较本组治疗前一时间点明显降低(均 P<0.01),且通心络组降低程度明显大于同期常规组(P<0.05或 P<0.01),以治疗 3个月后降低更显著(MMP-2:281.74±21.15比363.17±14.19,MMP-9:407.83±10.05比 523.05±9.78,均 P<0.01).通心络组总有效率明显高于常规组(91.4%比76.9%,P<0.05).结论通心络胶囊具有稳定动脉粥样斑块,减轻患者临床症状的作用,其作用机制可能与降低 UAP 患者血浆的 MMP-2/9水平有关.
目的觀察通心絡膠囊對不穩定型心絞痛(UAP)患者血漿基質金屬蛋白酶-2/9(MMP-2/9)水平的影響,初步探討其治療 UAP 的可能作用機製.方法採用前瞻性研究方法.將2010年2月至2011年6月本院收治的110例 UAP 患者按隨機數字錶法分為通心絡組(58例)和常規組(52例).常規組給予阿司匹林+辛伐他汀+硝痠酯類;通心絡組在常規組藥物治療基礎上加用通心絡膠囊3粒(0.26 g/粒),每日3次.同期選擇100例年齡匹配的本院健康查體者作為健康對照.採用酶聯免疫吸附試驗(ELISA)測定患者治療前及治療1、2、3箇月後的 MMP-2/9濃度.結果 UAP 患者 MMP-2/9(μg/L)水平均明顯高于健康對照組(MMP-2:448.09±11.90比215.56±14.74,MMP-9:624.94±12.12比384.41±21.74,均P<0.01).通心絡組與常規組治療前 MMP-2/9濃度相近(MMP-2:450.32±11.20比445.96±12.26,MMP-9:625.92±13.17比623.99±11.07,均P>0.05);隨治療時間延長,兩組治療後 MMP-2/9水平均較本組治療前一時間點明顯降低(均 P<0.01),且通心絡組降低程度明顯大于同期常規組(P<0.05或 P<0.01),以治療 3箇月後降低更顯著(MMP-2:281.74±21.15比363.17±14.19,MMP-9:407.83±10.05比 523.05±9.78,均 P<0.01).通心絡組總有效率明顯高于常規組(91.4%比76.9%,P<0.05).結論通心絡膠囊具有穩定動脈粥樣斑塊,減輕患者臨床癥狀的作用,其作用機製可能與降低 UAP 患者血漿的 MMP-2/9水平有關.
목적관찰통심락효낭대불은정형심교통(UAP)환자혈장기질금속단백매-2/9(MMP-2/9)수평적영향,초보탐토기치료 UAP 적가능작용궤제.방법채용전첨성연구방법.장2010년2월지2011년6월본원수치적110례 UAP 환자안수궤수자표법분위통심락조(58례)화상규조(52례).상규조급여아사필림+신벌타정+초산지류;통심락조재상규조약물치료기출상가용통심락효낭3립(0.26 g/립),매일3차.동기선택100례년령필배적본원건강사체자작위건강대조.채용매련면역흡부시험(ELISA)측정환자치료전급치료1、2、3개월후적 MMP-2/9농도.결과 UAP 환자 MMP-2/9(μg/L)수평균명현고우건강대조조(MMP-2:448.09±11.90비215.56±14.74,MMP-9:624.94±12.12비384.41±21.74,균P<0.01).통심락조여상규조치료전 MMP-2/9농도상근(MMP-2:450.32±11.20비445.96±12.26,MMP-9:625.92±13.17비623.99±11.07,균P>0.05);수치료시간연장,량조치료후 MMP-2/9수평균교본조치료전일시간점명현강저(균 P<0.01),차통심락조강저정도명현대우동기상규조(P<0.05혹 P<0.01),이치료 3개월후강저경현저(MMP-2:281.74±21.15비363.17±14.19,MMP-9:407.83±10.05비 523.05±9.78,균 P<0.01).통심락조총유효솔명현고우상규조(91.4%비76.9%,P<0.05).결론통심락효낭구유은정동맥죽양반괴,감경환자림상증상적작용,기작용궤제가능여강저 UAP 환자혈장적 MMP-2/9수평유관.
Objective To explore the possible mechanism of treating unstable angina pectoris(UAP)with Tongxinluo(TXL)through observing the effect of TXL on plasma levels of matrix metalloproteinase-2/9(MMP-2/9) in patients with UAP. Methods A perspective study was conducted. One hundred and ten cases of patients with UAP admitted into the hospital between February 2010 and June 2011 were randomly divided into a TXL group (58 cases)and a conventional group(52 cases). The patients in conventional group were treated with aspirin +simvastatin + nitrates ;TXL group was treated with the above conventional treatment and additionally 3 TXL capsules (0.26 g/capsule),3 times per day was applied. In the mean time,100 age-matched healthy cases who had taken medical checkup in our hospital were selected as healthy control. Enzyme-linked immunosorbent assay(ELISA)was used to measure MMP-2/9 concentrations of the patients before treatment and 1,2,3 months after treatment in both groups,respectively. Results The plasma levels of MMP-2/9(μg/L)in UAP patients were significantly higher than those in normal control cases(MMP-2:448.09±11.90 vs. 215.56±14.74,MMP-9:624.94±12.12 vs. 384.41±21.74, both P<0.01);before treatment,the levels of MMP-2/9 were not significantly different between the TXL group and conventional group(MMP-2 :450.32±11.20 vs. 445.96±12.26,MMP-9 :625.92±13.17 vs. 623.99±11.07,both P>0.05). As the treatment progressed longer,the MMP-2/9 concentrations in both patient groups became lower compared to those before the treatment(all P<0.01);moreover,the MMP-2/9 concentrations in the TXL group were significantly lower than those in the conventional group after treatment for 1,2 and 3 months respectively(P<0.05 or P<0.01),the most significant effect being at the time point of 3 months after treatment(MMP-2 :281.74±21.15 vs. 363.17±14.19,MMP-9 :407.83±10.05 vs. 523.05±9.78,both P<0.01). The total effective rate in TXL group was higher than that in the conventional group(91.4% vs. 76.9%,P<0.05). Conclusion TXL has the effect of stabilizing plaque of atherosis and relieving the clinical symptoms of patients with UAP,and its mechanism is possibly related to the reduction of plasma levels of MMP-2/9 in such patients.