丹参酮ⅡA磺酸钠注射液对冠心病心肌缺血的治疗作用

目的观察丹参酮ⅡA磺酸钠对冠心病心肌缺血的疗效及安全性。方法将77例冠心病患者随机分为A组40例与B组37例。B组常规应用硝酸异山梨酯与阿司匹林。A组在常规治疗基础上加用丹参酮ⅡA碘酸钠注射液。每例于治疗开始前1 d与结束次日,进行血脂、血液流变学与动态心电图(Holter)检测。结果A组查血脂示血清总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)明显下降(P均<0.01),B组TC、TG、LDL-C治疗前后均无显著性差异(P均>0.05)。A组血液流变学观察示低切变率下全血黏度、高切变率下全血黏度、血浆比黏度、红细胞聚集指数、红细胞比积、血小板聚集率、纤维蛋白原均显著下降(P<0.01或0.05),其改善血液流变学指标的疗效优于B组(P<0.05)。Holter监测示症状性心肌缺血与无症状心肌缺血的发作次数及其持续时间2组均明显减少(P<0.01或0.05),但A组比B组减少更为显著(P均<0.05)。在随访治疗过程中未见丹参酮ⅡA磺酸钠的严重不良反应。结论丹参酮ⅡA磺酸钠有降脂与改善血液流变性作用,是治疗冠心病心肌缺血的一种有效而安全的药物。

Therapeutic action of tanshinone IIA sulfonic acid natrium injection on myocardial ischemia of coronary artery disease

Objective It is to observe the clinical curative effect and safety of tanshinone ⅡA sulfonic acid natrium injection on myocardial ischemia of coronary artery disease (CAD). Methods Seventy-seven cases of CAD were randomly divided into group A (40 cases) and group B (37 cases). Group B was treated with sorbitrate and aspirin. Group A was treated with tanshinone ⅡA sulfonic acid natrium injection based on routine treatment. Blood lipids, hemorrheology and Holter were checked and measured at one day before and after treatment. Results In group A, the levels of TC, TG and LDL-C were lowered significantly (P<0.01). There was not significant difference on the levels of TC, TG and LDL-C before and after treatment in group B (P>0.05). Observation on hemorrhelology showed that whole blood viscosity under low or high shear rate, plasma viscosity rate, erythrocyte aggregation index, erythrocyte specific volume, platelet aggregation rate and fibrinogen were significantly reduced (P<0.01 or 0.05). The action of ameliorating hemorrhelogic parameters in group A was superior to that in group B (P<0.05). Holter monitor showed that frequency and sustained time of symptomatic and asymptomatic cardiac muscle ischemia were significantly decreased in two groups (P<0.01 or 0.05), but it decreased more significantly in group A than that in group B (P<0.05). No severe untoward reaction was found in follow up treating course. Conclusion Tanshinone IIA sulfonic acid natrium injection has lowering blood lipids and improving the conditions of hemorrhelolgy effect, so it is an effective and safe drug on myocardial ischemia of CAD.