冠心舒通胶囊联合氯吡格雷对急性心肌梗死并心力衰竭患者NT-proBNP及心功能的影响

Effect of Guanxin Shutong Capsule(冠心舒通胶囊)Combined with Clopidogrel on NT-proBNP and Heart Function in Patients with Acute Myocardial Infarction and Heart Failure

目的探讨冠心舒通胶囊联合氯吡格雷对急性心肌梗死并心力衰竭患者NT-proBNP及心功能的影响。方法纳入本单位2019年1月—2021年1月间确诊急性心肌梗死并心力衰竭的124例患者作为研究样本,基于随机数字表法进行分组,其中35例接受常规对症治疗+氯吡格雷治疗,为对照组;另35例在对照组的用药基础上增加冠心舒通胶囊治疗,为实验组。比较两组患者在系统给药治疗下的治疗有效率、心功能指标[左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)、左心室射血分数(LVEF)、心排血量(CO)、6min步行实验(6MWT)]、心率、收缩压及舒张压、可溶性生长刺激表达基因2蛋白(sST2)、氨基末端脑钠肽前体(NT-proBNP)及不良反应发生率、随访预后情况。结果高实验组总有效率高于对照组,且治疗后的实验组患者心率及血压水平均明显低于对照组(P<0.05)。治疗前,两组患者的心功能指标对比均无统计学意义(P>0.05);治疗后,两组患者的心功能指标均有不同程度的好转,但实验组LVESV、LVEDV水平低于对照组,LVEF、CO水平高于对照组,6MWT长于对照组,且实验组sST2、NT-proBNP水平均低于对照组(P<0.05);两组不良反应发生率相比无明显区别(P>0.05),但随访结局显示实验组治疗后再入院率明显更低(P<0.05)。结论冠心舒通胶囊联合氯吡格雷对急性心肌梗死并心力衰竭的心功能具有明显的改善作用,且联合用药未增加药物不良反应,为患者争取良性预后,值得推广。

Objective To investigate the effect of Guanxin Shutong Capsule(冠心舒通胶囊)combined with clopidogrel on N-terminal pro-brain natriuretic peptide(NT-proBNP)and cardiac function in patients with acute myocardial infarction and heart failure.Methods A total of 124 patients with acute myocardial infarction and heart failure diagnosed in the hospital between January 2019 and January 2021 were included as research samples,and grouped based on the random number table method,35 of which received conventional symptomatic treatment+clopidogrel treatment were the control group.The other 35 cases treated with Guanxin Shutong Capsules on the basis of the control group were the experimental group.The treatment effectiveness and cardiac function indexes[left ventricular end-systolic volume(LVESV),left ventricular end-diastolic volume(LVEDV),left ventricular ejection fraction(LVEF),cardiac output volume(CO),6-min walking test(6 MWT)],heart rate,systolic and diastolic blood pressure,soluble growth-stimulating expression gene 2 protein(sST2),NT-proBNP,the incidence of adverse reactions and the prognosis of follow-up of two groups were observed and compared.Results The total effective rate of the experimental group was higher than that of the control group,and the heart rate and blood pressure levels of the experimental group after treatment were significantly lower than those of the control group(P<0.05).Before treatment,the comparison of the cardiac function indexes of the two groups was not statistically significant(P>0.05).After treatment,the cardiac function indexes of the two groups were improved to varying degrees,but the levels of LVESV and LVEDV in the experimental group were lower than those in the control group and the levels of LVEF and CO were higher than those of the control group.The 6 MWT was longer than that of the control group,and the levels of sST2 and NT-proBNP in the experimental group were lower than those of the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05),but the follow-up results showed that the re-admission rate after treatment in the experimental group was significantly lower(P<0.05).Conclusion Guanxin Shutong Capsule combined with clopidogrel can significantly improve the heart function of acute myocardial infarction and heart failure,and the combination does not increase the side effects of the drug.It is worthy of promotion for the patients to strive for a benign prognosis.