| Cardiovascular and cerebrovascular diseases are common serious harm to human health and the frequently-occurring diseases. They have become the leading cause of human death. Among them, coronary heart disease (CHD) is the world's most dangerous heart attack within and is China's adult heart disease hospitalization and the first cause of death. The morbidity and mortality is still an upward trend. Recent data show that coronary heart disease each year in China is not only rapid increase in hospital visits, and the average cost of hospitalization in the first out in a variety of diseases.The basis of coronary heart disease is atherosclerosis. Atherosclerotic lesions progress, especially in vulnerable plaque rupture due to platelet aggregation and thrombosis is the main reason for acute coronary events. Atherosclerosis is a systemic vascular disease, generally the most common in the coronary, carotid and other large and medium systemic arteries. Impaired endothelial function and dysfunction play an important role in the pathogenesis. Previous studies showed that:Atherosclerosis is a progressive linear development process. Under the formation of intimal lipid plaques gradually increasing convex into the lumen, resulting in a narrow lumen and tissue ischemia, leading to acute cardiovascular events.Secondary prevention of coronary heart disease is one of the basic strategy for prevention and treatment of coronary heart disease. Goal is to reduce coronary heart disease and coronary heart disease risk among the event occurrence or recurrence of acute risk of, to protect myocardial and improve survival and quality of life in patients with coronary heart disease. Aimed at reducing morbidity and mortality of coronary heart disease and a range of cardiovascu-lar and cerebrovascular events in a variety of drug treatment, the theoretical basis of drug treatment is anti-atherosclerotic lesions.Sodium ferulate(SF) is my own research and development of a new class of non-peptide endothelin receptor antagonist, the role of a wide range, including antagonizing the vasoconstriction and high blood pressure caused by endothelin, inhibiting vascular smooth muscle booster, increasing NO synthesis, relaxing Smooth muscle, anti-platelet, anticoagulation, reducing blood fat, preventing lipid peroxidation, anti-inflammatory and anti-apoptosis. Therefore, this study intends to observe drug efficacy, arterial elasticity and endothelial function in patients with unstable angina treated with Sodium ferulate(SF) and to explore the relevant mechanisms.Objective1. To observe effect of the long-term application of sodium ferulate on unstable angina patients.2. To observe effect of the long-term application of sodium ferulate on artery elasticity in patients with unstable angina, and to explore its possible mechanism.3. To observe effect of the long-term application of sodium ferulate on endothelial function in patients with unstable angina, and to explore its possible mechanism.Methods1. Object and grouping Subjects and groups:120 patients with unstable angina patients, in line with 1979 WHO diagnostic criteria for unstable angina pectoris, were enrolled and randomly divided into treatment group and control group. Based on the routine drug therapy, treatment group was treated with Sodium ferulate(SF) 400mg/day, while control group placebo per day. During the period of clinic trial, the eating habits and lifestyle of subjects were maintained. The original drug for the treatment of coronary heart disease, high blood pressure or other complications may continue to apply. The treatment is of 6 months, monthly up visit.2. The Serum CRP, NO and cystatin C Measurement Serum CRP, NO, Cystatin C Check:before and after the start of treatment 1 month,3 months and 6 months, the levels of serum CRP, NO, Cystatin C content were measured. Simultaneous, the levels of blood glucose, cholesterol (TC), triglyceride (TG), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), and liver and renal function indicators were measured.3. PWV Measurement Before treatment and 1 month,3 months and 6 months after the starting treatment PWV examination was underwent.4. Statistical analysis Software SPSS 11.5 was applicated for statistical analysis. Count data was described as the number and percentage of patients. Measured data was described as mean±standard deviation.χ2 test was used to compare count data between the two groups.t test was used to compare measurement data between the two groups. P<0.05 is for a significant difference.Results1. Comparison of general subjects 120 patients with unstable angina pectoris were enrolled in the study. Interruption of treatment in 2 cases occurred in the treatment group due to lost. In placebo control group,2 cases withdraw because of gastrointestinal discomfort symptoms after taking medicine and 1 case stopped treatment because of rehospitalization for the recurrence of non-fatal myocardial infarction. The final total of 115 patients completed the study, in which SF treatment group 58 patients, placebo-control group 57 patients. At the beganing of the trial,the two groups'comparable basic situation (age, body mass index, blood pressure, heart rate, gender ratio, smoking history, drinking history, complications of hypertension and diabetes) and combination therapy (aspirin, (3 receptor blocking hysteresis agents, angiotensin converting enzyme inhibitors, lipid nitrate, calcium antagonist) were well matched (P>0.05). 2. Biochemical indicators Body mass index(BMI), TC, TG, HDL-C, LDL-C and blood glucose levels showed no significant difference before and after treatment in the two groups(P>0.05).3. Serum CRP level There were no significant difference in serum CRP between the two groups before treatment (P>0.05). After SF treatment 1 month,3 months and 6 months, the CRP levels decreased to varying degrees. Compared with the control group, the CRP levels also decreased significantly during the same time (P<0.05). The CRP levels before and after treatment in control group, had no significant changes and statistically significant (P>0.05).4. Serum NO level Before treatment, there was no significant difference in serum NO levels in the two groups (P>0.05). After SF treatment 1 month,3 months and 6 months, the CRP levels increased to varying degrees. Compared with the control group, the NO levels also increased significantly during the same time (P<0.05). The NO-level before and after treatment in control group had no significant changes and statistically significant (P>0.05).5. Serum cystatin C level Before treatment, there was no significant difference in serum Cystain C levels in the two groups (P>0.05). After SF treatment 1 month,3 months and 6 months, the Cystain C levels decreased to varying degrees. Compared with the control group, the Cystain C levels also decreased significantly during the same time (P<0.05). The Cystain C levels before and after treatment in control group, had no significant changes and statistically significant (P>0.05).6. PWV level Before treatment, there was no significant difference in PWV level in the two groups (P>0.05). After SF treatment 3 months and 6 months, the PWV-CR, PWV-CF and PWV-CD levels decreased to varying degrees. Compared with the control group, the PWV-CR, PWV-CF and PWV-CD levels also decreased significantly during the same time (P<0.05). The PWV-CR, PWV-CF and PWV-CD levels before and after treatment in control group, had no significant changes and statistically significant (P>0.05). Conclusion1. Long-term use of sodium ferulate use can improve endothelial function and reduce inflammation.2. Long-term use of sodium ferulate has a protective effect on arterial elasticity. |
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