CAJ | 학술논문

目的：研究丹参多酚酸盐对急性心肌梗死（AMI）的临床疗效。方法选择2012年1月至2014年1月巴中市中心医院心血管内科确诊为AMI 的患者131例，男性75例，女性56例，年龄范围45~75岁。随机分为治疗组（n=65）和对照组（n=66）。两组的治疗均按急性心肌梗死指南进行，治疗组在指南治疗基础上加用丹参多酚酸盐静脉滴注，200 mg/d，疗程7 d。分别在入院时（D0），入院第3 d （D3）、第7 d（D7）和第14 d（D14）进行左室射血分数（LVEF）、血清B型脑钠肽（BNP）、总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、白细胞计数（WBC）以及C反应蛋白（CRP）等指标检测。比较两组住院30 d内死亡率及住院期间室性心律失常发生率。结果在D3、D7时，治疗组血清BNP水平明显低于对照组，LVEF高于对照组，差异有统计学意义（P均＜0.05）。在D7、D14时，治疗组LDL-C和TC水平明显低于对照组，差异有统计学意义（P均＜0.05）。治疗组血清CRP水平在D3、D7、D14均低于对照组，在D3和D7时，治疗组WBC高于对照组，D14时低于对照组，差异有统计学意义（P均＜0.05）。住院期间，治疗组和对照组各有4例和5例（6.2%vs.7.6%）发生室性心动过速，各有8例和6例（12.3%vs.9.1%）发生频发室早，差异均无统计学意义（P均＞0.05）。治疗组和对照组30 d内分别有8例死亡（12.3%vs.12.1%），差异无统计学意义（P=0.974）。治疗组和对照组住院天数中位数分别为10 d和13 d，治疗组低于对照组，通过Log-rank检验，有统计学差异（P=0.0078）。结论丹参多酚酸盐能够改善心功能，缩短住院时间，减轻炎症反应，同时还具有降低TC和LDL-C等多方面的药理作用。
목적：연구단삼다분산염대급성심기경사（AMI）적림상료효。방법선택2012년1월지2014년1월파중시중심의원심혈관내과학진위AMI 적환자131례，남성75례，녀성56례，년령범위45~75세。수궤분위치료조（n=65）화대조조（n=66）。량조적치료균안급성심기경사지남진행，치료조재지남치료기출상가용단삼다분산염정맥적주，200 mg/d，료정7 d。분별재입원시（D0），입원제3 d （D3）、제7 d（D7）화제14 d（D14）진행좌실사혈분수（LVEF）、혈청B형뇌납태（BNP）、총담고순（TC）、저밀도지단백담고순（LDL-C）、백세포계수（WBC）이급C반응단백（CRP）등지표검측。비교량조주원30 d내사망솔급주원기간실성심률실상발생솔。결과재D3、D7시，치료조혈청BNP수평명현저우대조조，LVEF고우대조조，차이유통계학의의（P균＜0.05）。재D7、D14시，치료조LDL-C화TC수평명현저우대조조，차이유통계학의의（P균＜0.05）。치료조혈청CRP수평재D3、D7、D14균저우대조조，재D3화D7시，치료조WBC고우대조조，D14시저우대조조，차이유통계학의의（P균＜0.05）。주원기간，치료조화대조조각유4례화5례（6.2%vs.7.6%）발생실성심동과속，각유8례화6례（12.3%vs.9.1%）발생빈발실조，차이균무통계학의의（P균＞0.05）。치료조화대조조30 d내분별유8례사망（12.3%vs.12.1%），차이무통계학의의（P=0.974）。치료조화대조조주원천수중위수분별위10 d화13 d，치료조저우대조조，통과Log-rank검험，유통계학차이（P=0.0078）。결론단삼다분산염능구개선심공능，축단주원시간，감경염증반응，동시환구유강저TC화LDL-C등다방면적약리작용。
Objective To study the curative effect of salvianolate on acute myocardial infarction (AMI). Methods The AMI patients (n=131, male 75, female 56 and aged from 45 to 75) were chosen from Jan. 2012 to Jan. 2014, and then randomly divided into treatment group (n=65) and control group (n=66). The treatment was given to 2 groups according to AMI treatment guideline, and treatment group was additionally given intravenous drip of salvianolate (200 mg/d) for 7 d. The indexes of LVEF, brain natriuretic peptide (BNP), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), white blood cells count (WBC) and C-reactive protein (CRP) were detected at different time points including hospitalized time (d0), and after hospitalized for 3 d (d3), 7 d (d7) and 14 d (d14). The mortality within 30 d after hospitalization and incidence of ventricular arrhythmias during hospitalization were compared between 2 groups. Results At d3 and d7, BNP was significantly lower and LVEF was higher in treatment group than those in control group (all P<0.05). At d7 and d14, LDL-C and TC were significantly lower in treatment group than those in control group (all P<0.05). CRP was lower at d3, d7 and d14, and WBC was higher at d3 and d7 and lower at d14 in treatment group than those in control group (all P<0.05). During hospitalization there were 4 cases in treatment group and 5 in control group with ventricular tachycardia (6.2%vs. 7.6%), and 8 in treatment group and 6 in control group with frequent premature ventricular contraction (12.3%vs. 9.1%, all P>0.05). There were 8 cases died in treatment group and 8 cases died in control group (12.3%vs. 12.1%) within 30 d after hospitalization (P=0.974). The hospitalizing days were 10 d in treatment group and 13 d in control group (P=0.0078 by Log-rank test). Conclusion Salvianolate can improve heart function, shorten hospitalization time, relieve inflammatory reactions and reduce levels of TC and LDL-C.