Efficacy and safety of sodium tanshinone ⅡA sulphonate in the treatment of patients with acute exacerbations of chronic obstructive pulmonary disease complicated with chronic pulmonary heart disease

DUAN Lin-li; REN Ni; WANG Guan-li; HE Meng-zhang; JIANG Qian; LIU Chun-li

doi:10.13820/j.cnki.gdyx.20230800

Abstract：Objective To investigate the efficacy and safety of sodium tanshinone Ⅱ A sulphonate(STS)in the treatment of acute exacerbations of chronic obstructive pulmonary disease(AECOPD)complicated with chronic pulmonary heart disease.Methods Fifty-three eligible patients with AECOPD and pulmonary heart disease were randomly as-signed using a 2∶1∶1 ratio into three groups:STS group(n=25),heparin group(n=16),and control group(n=12).The control group received routine treatment,the STS group received STS at a dose of 1.5 mg/kg on top of routine treat-ment,and the heparin group received low molecular weight heparin sodium injection(enoxaparin)at a dose of 100 AxaIU/kg on top of routine treatment.The treatment course for all groups was 10 days.The changes in pulmonary artery systolic pressure(PASP),right heart function,hemorheology,exercise endurance,and adverse reactions were compared among the three groups before and after treatment.Results The STS group showed a significant decrease in PASP after treatment(P＜0.05),with a significant difference compared to the heparin group(P=0.033).In the STS group,the Tei index of the right ventricular myocardial work,right ventricular full display section ejection fraction(EF),the ratio of late diastolic A-wave peak(TVA),and TVA to early diastolic E-wave peak of the tricuspid valve(TVA/TVE)all showed significant differences before and after treatment(P＜0.05).There were significant differences of TVA and TVA/TVE between STS group and heparin group after treatment(P＜0.05).TVA in heparin group was significantly different from that in control group after treatment(P＜0.05).In terms of hemorheology,the plasma viscosity,medium shear whole blood reduced viscosity,and D-Dimer in the heparin group were decreased significantly after treatment(P＜0.05);there was significant difference of fibrinogen in STS group before and after treatment(P＜0.05).After treatment,the medium shear whole blood reduced viscosity in STS group was significantly different from that in heparin group(P=0.001),while the plasma viscosity and medium shear whole blood reduced viscosity between heparin group and control group were significantly different(P=0.012、0.001).There was no significant difference in the medium shear whole blood reduced viscosity,fibrinogen,and D-Dimer between the three groups after treatment(P＞0.05).The 6-minute walking distance improved significantly in all three groups after treatment(P＜0.05).The Saint George's respiratory questionnaire(SGRQ)score showed statistically significant improvement in respiratory symptoms(SS)in the STS group before and after treatment(P＜0.01),while the other two groups showed no significant change(P＞0.05).No adverse reactions occurred in any of the three groups.Conclusion Application of STS in AECOPD patients with pulmonary heart disease can improve PASP,right heart function,and exercise endurance,warranting clinical promotion.However,further clinical verification is needed to determine whether it can improve blood viscosity.