目的 探讨大剂量瑞舒伐他汀联合疏血通注射液对不稳定型心绞痛(unstable angina pectoris ,UAP)患者心电图及血清低氧诱导因子-1α(HIF-1α)、可溶性CD40配体L(sCD40L)水平变化的影响。方法 选取2014-07至2017-09我院UAP患者108例,按随机数字表法分为实验组与对照组,每组54例。两组均予以常规治疗,对照组采用大剂量瑞舒伐他汀治疗,实验组采用大剂量瑞舒伐他汀联合疏血通注射液治疗,治疗14 d后统计两组临床效果、心电图疗效、不良反应发生率,并比较两组治疗前后血液流变学指标(纤维蛋白原、红细胞压积、血浆黏度)及血清HIF-1α、sCD40L水平。结果 治疗14 d后实验组临床效果与心电图疗效的总有效率分别为83.33%、87.04%,均高于对照组的61.11%、68.52%,两组对比差异有统计学意义(P<0.05);实验组治疗14 d后纤维蛋白原、红细胞压积、血浆黏度水平分别为(3.69±0.64)g/L、(0.37±0.08)%、(1.40±0.25)mPa/s,均低于对照组的(4.31±0.76)g/L、(0.48±0.10)%、(1.63±0.38)mPa/s,两组对比差异有统计学意义(P<0.05);实验组治疗14 d后血清HIF-1α、sCD40L水平分别为(426.27±17.40)pg/ml、(11.03±1.22)μg/L,均低于对照组的(532.43±19.15)pg/ml、(14.27±1.40)μg/L,两组对比差异有统计学意义(P<0.05);实验组不良反应发生率14.81%与对照组11.11%对比,差异无统计学意义。结论 给予不稳定型心绞痛患者大剂量瑞舒伐他汀联合疏血通注射液治疗可显著改善临床效果及患者心电图情况,降低血清HIF-1α、sCD40L水平,改善血液流变学状况,且安全性良好。

Objective To investigate the effect of large doses of rosuvastatin combined with Shuxuetong injection on the changes of electrocardiograms and serum levels of hypoxia inducible factor -1α (HIF-1α) and soluble CD40 ligand L (sCD40L) in patients with unstable angina pectoris(UAP).Methods A total of 108 cases of UAP patients treated in our hospital between July 2014 and September 2017 were selected and divided into the experimental group and the control group according to the random number table,each with 54 cases. Both groups were given conventional treatment. In addition,the control group was treated with high-dose rosuvastatin,while the experimental group was treated with high-dose rosuvastatin combined with Shuxuetong injection. Both groups were treated for 14 days. The clinical effect,difference in electrocardiograms and incidence of adverse reactions of the two groups were statistically recorded. The hemorheological indexes (fibrinogen,hematocrit and plasma viscosity) and serum levels of HIF-1α and sCD40L were compared between the two groups before treatment and after 14 days of treatment.Results After 14 days of treatment, the total effective rate and rate of clinical effect on electrocardiograms in the experimental group were 83.33% and 87.04% respectively, higher than 61.11% and 68.52% of the control group(P<0.05). After 14 days of treatment, the levels of fibrinogen and hematocrit and plasma viscosity of the experimental group were (3.69±0.64)g/L, (0.37±0.08)% and (1.40±0.25)mPa·s respectively, lower than (4.31±0.76)g/L, (0.48±0.10)% and (1.63±0.38)mPa·s of the control group(P<0.05). After 14 days of treatment, the levels of serum HIF-1α and sCD40L of the experimental group were (426.27±17.40)pg/ml and (11.03±1.22)μg/L respectively, lower than (532.43±19.15)pg/ml and (14.27±1.40)μg/L of the control group(P<0.05). There was insignificant difference in the incidence of adverse reactions between the experimental group (14.81%) and the control group (11.11%)(P>0.05).Conclusions Large doses of rosuvastatin combined with Shuxuetong injection in treating patients with unstable angina pectoris can significantly improve the clinical effect and the patients’ electrocardiograms,reduce the levels of serum HIF-1α and sCD40L,and improve hemorheology. Moreover, this approach is quite safe.