目的:探讨不稳定性心绞痛(UA)患者住院早期应用丹参多酚酸盐后血清一氧化氮(NO)、超氧化物歧化酶(SOD)以及丙二醛(MDA)的变化及其临床意义。方法:将40例UA患者随机均分为治疗组和对照组,各20例。两组均常规应用硝酸酯类、β-受体阻滞剂、钙拮抗剂、低分子肝素和阿司匹林治疗,治疗组另外给予丹参多酚酸盐(100mg/d)治疗,疗程均为14天。分别使用硝酸还原酶法、羟胺法与硫代巴比妥酸法检测两组治疗前后血清NO、SOD及MDA的水平。随访2个月,观察两组治疗后主要心脏事件(MACE)以及不良反应。结果:治疗组与对照组在住院14天内治疗总有效率分别为90%与65%(P〈0.05)。与对照组相比,治疗组血清NO和SOD水平显著增高,血清MDA水平显著降低,两组比较差异有统计学意义(P〈0.05)。随访2个月,MACE发生率分别为15%与45%(P〈0.05),且两组均未出现任何不良反应。结论:丹参多酚酸盐注射液治疗不稳定性心绞痛安全、有效,可显著提高治疗有效率,降低MACE发生的风险,其机制可能与其清除氧自由基、增强心肌抗氧化能力、抑制脂质过氧化有关。
Objective : To investigate the clinical curative effect of salvianolate on Patients with unstable angina ( UA ), and the levels and the changes of serum nitric oxide ( NO ), superoxide dismutase ( SOD ) and malondialdehyde ( MDA ) .The results try to explore the possible anti- atheroslerotic mechanism of Salvianolate. Methods : Forty patients with UA were randomly divided into the therapy group ( salvianolate set ) and the control group with 20 cases in each. All patients were treated with conventional drugs such as nitrates, beta- blocker, calcium channel blocker, low molecular heparin and aspirin, while the therapy group was administered with salvianolate ( 100mg/d ) additionally. Every group was treated for 14 days. The serum levels of NO, SOD and MDA before and after the treatments were measured by using nitrate reductase method, hydroxylamine method and thiobarbituric acid ( TBA ) method, respectively. All patients were followed up for 2 months. The major adverse cardiac events ( MACE ) and drug adverse reactions were observed in both groups. Results: After the treatment, the total effective rates were 90% in the therapy group and 65% in the control group ( P〈0.05 ). Compared with the control group, the levers of NO and SOD increased and the level of MDA decreased obviously in the therapy group ( P〈0.05 ). After two months of follow-up, the total incidence rates of MACE were 15% in the therapy group and 45% in the control group (P〈0.05). There was statistical significance between the two groups, and there was no adverse reaction in both groups. Conclusions : Salvianolate Injection therapy is effective and safe for patients with UA .It can improve the clinical therapeutic effect and decrease the risk of MACE significantly .The mechanism may be at least partly related with scavenging oxygen free radical, enhancing the antioxidation property of cardiac muscle and inhibiting lipid peroxidation.