血必净注射液治疗急性非ST段抬高型心肌梗死的临床观察

Clinical Observation of Xuebijing Injection in the Treatment of Acute Non-ST Elevation Myocardial Infarction

目的:探讨血必净注射液对急性非ST段抬高型心肌梗死(NSTEMI)患者的炎症因子、氧化应激水平和血栓风险的影响以及用药安全性。方法:选取2015年5月-2016年8月我院收治的NSTEMI患者130例作为研究对象,按照随机数字表法分为对照组和观察组,各65例。对照组患者给予降压、降脂、抗凝和抗血小板等常规治疗;观察组患者在对照组基础上给予血必净注射液50 m L,ivgtt,q12 h。两组患者均连续治疗1周。观察两组患者治疗前后血清炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、IL-10和超敏C反应蛋白(hs-CRP)]、超氧化物歧化酶(SOD)、丙二醛(MDA)、基质金属蛋白酶9(MMP-9)、血小板集聚率和纤维蛋白原水平,并记录治疗过程以及治疗后1个月内MACE和出血事件的发生情况。结果:治疗前,两组患者炎症因子、SOD、MDA、MMP-9、血小板集聚率和纤维蛋白原水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者TNF-α、IL-6、hs-CRP、血小板聚集率和纤维蛋白原水平均明显降低,IL-10水平明显升高,且观察组患者上述指标改善程度均明显优于对照组。两组患者SOD和MMP-9水平均明显升高,MDA水平明显降低;观察组患者SOD水平明显高于对照组,MDA水平明显低于对照组,但MMP-9水平明显低于对照组,差异均有统计学意义(P<0.05)。两组患者的MACE发生率(16.92%vs.20.00%)和出血事件发生率(4.62%vs.7.69%)比较,差异均无统计学意义(P>0.05)。结论:血必净注射液治疗NSTEMI疗效显著,可有效抑制患者的炎症和氧化应激水平,降低血栓形成风险,且安全性较高。

OBJECTIVE：To investigate the effects of Xuebijing injection on inflammatory factors,oxidation stress level and thrombosis risk in patients with acute non-ST elevation myocardial infarction（NSTEMI）. METHODS：A total of 130 NSTEMI pa-tients selected from our hospital during May 2015-Aug. 2016 were divided into control group and observation group according to random number table,with 65 cases in each group. Control group was given routine treatment as lowering blood pressure,lowering lipid,anticoagulation and antiplatelet. Observation group was additionally given Xuebijing injection 50 m L,ivgtt,q12 h,on the basis of control group. Both groups were treated for a week. The levels of inflammatory cytokines（TNF-α,IL-6,IL-10,hs-CRP）,SOD,MDA,MMP-9,platelet aggregation rate and fibrinogen were observed in 2 groups before and after treatment.The treatment course,the occurrence of MACE and bleeding event were also recorded. RESULTS：Before treatment,there was no statistical significance in the levels of inflammatory factors,SOD,MDA,MMP-9,platelet aggregation rate or fibrinogen between2 groups（P〈0.05）. After treatment,the levels of TNF-α,IL-6,hs-CRP,platelet aggregation rate or fibrinogen in 2 groups were decreased significantly,while the level of IL-10 was increased significantly;the improvement of above indexes in observation group was significantly better than control group. The levels of SOD and MMP-9 in 2 groups were increased significantly,while the level of MDA was decreased significantly. The level of SOD in observation group was significantly higher than control group,while the level of MDA was significantly lower than control group,but the level of MMP-9 was significantly lower than control group, with statistical significance（P〈0.05）. There was no statistical significance in the incidence of MACE（16.92% vs.20.00%）or bleeding event（4.62% vs. 7.69%）between 2 groups（P〈0.05）. CONCLUSIONS：Xuebijing injection shows significant therapeutic efficacy for NSTEMI,effectively inhibits inflammation,and oxidative stress and reduces the risk of thrombosis with good safety.