复方丹参滴丸预防高原心肌低氧症作用的研究

目的研究复方丹参滴丸(CSDP)预防高原心肌低氧症(HAMH)效果与作用机理。方法平原医学体检正常者进入海拔5 000 m高原的施工群体617人,随机分为CSDP服药组(186人)和对照组(431人),观察6个月期间,进行心电图、血压、血氧饱和度(SpO2)及H2S血清浓度检测。另设雄性Wistar大鼠CSDP干预组和对照组各7只,在同一海拔饲养20 d后处死做病理常规形态学及Hitachi-500电镜下观察摄片。结果与对照组比较:CSDP对初入高原劳动者心电图心肌缺血保护率即相对危险度降低0.57(人数)、0.70(人次),均P<0.01,效果指数为0.23(人数)、0.34(人次);使运动平板心电图预测35%预期发生心肌缺血的人免于发病(P<0.01);对已发生心电图心肌缺血阳性者服用CSDP后短期内净恢复率为38.94%(P<0.01);提高血清H2S含量(P<0.05),明显降低血压、心率及二者乘积、SpO2的异常率(P<0.05或P<0.01);偏相关分析结果CSDP与心肌缺血和生理参数的改善有密切相关性(P<0.05或P<0.01),能预防、改善大鼠心肌细胞的低氧性水肿、变性、坏死、组织淤血、出血及超微结构的损害。结论CSDP预防HAMH效果显著、起效迅速、作用确切、机制广泛,是符合HAMH发病机理、病理生理和防治要求的药物。

Effects of Composite Salviae Dropping Pill on Prevention in High Altitude Myocardial Hypoxidosis

Objective To evaluate the prevention effects and mechanisms of composite salviae dropping pill(CSDP) in high altitude myocardial hypoxidosis(HAMH).MethodsA random sample of 617 workers examined for good health at sea level entered an elevation of 5 000 m.The workers were random divided into a medication group(n=186) and a control group(n=431) and underwent ECG,blood pressure examination,SpO2test,and serum content of H2S test for 6 months.Additionally a Wistar rat experimentation sample were also divided into intervention group(n=7) and control group(n=7) and put under the same elevation and conditions as the human test sample.After 20 days the rats were put to death and observed with light microscope and transmission electron microscope.Results Compared with control group: the relative risk of HAMA was reduced by 0.57(by people) or 0.70(by cases)(P<0.01),efficiency index is 0.23 by number of people or 0.34 by cases and the anticipation of myocardial ischemia tested by movement ECG was reduced by 0.35(P<0.01).For the people with myocardial ischemia,after taking CSDP their recovery rate was 0.39(P<0.01),the serum content of H2S rose(P<0.05),the abnormality of blood pressure decreased,and SpO2was reduced(P< 0.05 orP< 0.01).The partial correlation analysis showed that the CSDP has close relationship with the effects mentioned above(P<0.05 orP< 0.01) and can prevent myocardial cell oedema,denaturation,necrosis,tissue congestion,hemorrhage,and ultrastructure damage in rats caused by hypoxemia.Conclusion CSDP has obvious effects,widespread mechanisms,and is able to fulfill the demand of pathogenesis and pathophysiology to prevent and treat HAMH.