丹参酮注射液对心肌再灌注损伤保护作用及其不同中医证型的疗效差异

目的观察丹参酮注射液对心肌再灌注损伤的保护作用及可能的作用机制。方法选择因急性胸痛就诊并确诊的急性冠脉综合征（ACS）,行冠状动脉介入治疗（PCI）患者60例。随机分为常规对照组、西药治疗组和丹参酮治疗组（分实证、虚证）,各20例,分别在术前、术后24h、术后7d检测血清炎症因子白介素-6（IL-6）、白介素-10（IL-10）、肿瘤坏死因子-α（TNF-α）、氧化应激因子一氧化氮（NO）、超氧化物歧化酶（SOD）、丙二醛（MDA）等指标。结果 PCI术前、术后24h比较炎症因子、氧化应激因子水平均有显著改变（P〈0.05）。PCI术后7d,西药治疗组和丹参酮治疗组炎症因子、氧化应激因子水平的改善优于常规对照组（P〈0.05）。丹参酮治疗组与西药治疗组比较无统计学意义（P〉0.05）,丹参酮对实证组的炎症因子和氧化应激因子的改善作用略优于虚证组,但无统计学意义（P〉0.05）。结论丹参酮注射液对心肌再灌注损伤有一定的保护作用,调节炎症因子和氧化应激因子水平是其主要的作用机制,其作用与磷酸肌酸相似;丹参酮注射液对实证型患者有更好的作用。

Effects of Tanshinone Injection on Myocardial Ischemia-reperfusion Injury and Different Syndromes of TCM

Objective To evaluate the effect of Tanshinone injection on myocardial ischemia-reperfusion injury and possible mechanism.Methods Sixty patients with percutaneous coronary intervention（PCI） were randomly divided into control group,drug treatment group and Tanshinone injection group（divided into sthenia syndrome group and deficiency syndrome group）.The changes of inflammatory cytokines [interleukin-6（IL-6）,IL-10,tumor necrosis factor α（TNF-α）] and oxidative stress factors [nitric oxide（NO） content,superoxide dismutase（SOD） and malondialdehyde（MDA）]were tested before surgery,24 hours and 7 days after surgery.Results Compared the 24 hours after PCI with the pre-operation,the levels of inflammatory cytokines and oxidative stress factors were changed significantly（P0.05）.The levels of inflammatory cytokines and oxidative stress factors in drug treatment and Tanshinone injection groups at 7 days after PCI were better than that in control group（P0.05）.The levels of inflammatory cytokines and oxidative stress factors were no difference between Tanshinone injection group and drugs treatment group（P0.05）.The levels of inflammatory cytokines and oxidative stress factors in sthenia syndrome group treated by Tanshinone injection at 7 days after PCI were better than that of deficiency group,but there was no difference（P0.05）.Conclusion Tanshinone injection has a protective effect on myocardial ischemia-reperfusion injury,which may be related with regulating the level of inflammatory cytokines and oxidative stress factors.Tanshinone injection has better effect on the patients with sthenia syndrome of TCM after PCI.