CAJ | 학술논문

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。
목적：관찰단삼동ⅡA광산납연합아탁벌타정대관심병환자혈장내피소1（ET-1）、뇌납태（BNP）수평적영향，탐토단삼동ⅡA광산납치료관심병적가능궤제。방법선취관심병환자160례，동기진행건강체검적정상인100례작위대조。분별채용방사면역법화매련면역흡부실험（ ELISA）측정혈장ET-1、BNP수평。장160례관심병환자수궤분위관찰A조화관찰B조，매조80례，관찰A조재상규치료기출상급여아탁벌타정치료，관찰B조재관찰A조기출상가용단삼동ⅡA광산납주사액，료정위30 d，관찰2조치료전후좌심실사혈분수（ LVEF）、좌심실수축말기내경（ LVESD）、좌심실서장말기내경（ LVEDD）급혈장ET-1、BNP수평。동시비교2조생활질량개선상황。결과여대조조비교，관심병환자조혈장ET-1、BNP수평현저승고，차이유통계학의의（ P ＜0 I．05）；차수착심공능분급급관맥병변엄중정도적증가，혈장ET-1、BNP수평축점승고，차이유통계학의의（P＜0．05）。혈장ET-1、BNP수평여심공능급관맥병변엄중정도정정상관（ P ＜0．05）。여치료전비교，치료후관찰A조화관찰B조ET-1、BNP수평현저강저，차이유통계학의의（ P ＜0．05），단관찰B조강저정도경명현，차이유통계학의의（ P ＜0．05）。관찰B조생활질량개선정도현저우우관찰A조，차이유통계학의의（P＜0．05）。결론단삼동ⅡA광산납연합아탁벌타정치료능구유효개선환자심공능，기궤제여강저혈장ET-1、BNP수평유관。
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.