丹红注射液联合阿替普酶静脉溶栓治疗老年急性心肌梗死的疗效观察

Curative effect of Danhong Injection combined with intravenous atyplase thrombolysis in elderly acute myocardial infarction patients

目的探讨丹红注射液联合阿替普酶静脉溶栓对老年急性心肌梗死(AMI)患者心肌纤维化及心室重构的影响。方法选取我院收治的老年AMI患者176例,随机分为对照组和观察组,每组88例。对照组给予阿替普酶静脉溶栓治疗,在此基础上,观察组加用丹红注射液治疗。检测半乳凝素3(Gal-3)、转化生长因子β1(TGF-β1)、结缔组织生长因子(CTGF)、脂联素等心肌纤维化指标及NF-κB、胱抑素C(CysC)、基质金属蛋白酶9(MMP-9)、成纤维细胞生长因子23(FGF-23)等心室重构相关指标水平。观察2组临床疗效及主要不良心血管事件(MACE)发生率。结果与治疗前比较,治疗后2组Gal-3、TGF-β1、CTGF、NF-κB、胱抑素C、MMP-9、FGF-23、左心室重构指数(LVRI)、左心室质量指数(LVMI)、右心室收缩末期容积(RVESV)及右心室舒张末期容积(RVEDV)明显降低,而脂联素明显升高(P<0.05),且观察组Gal-3、TGF-β1、CTGF、NF-κB、胱抑素C、MMP-9、FGF-23、LVRI、LVMI、RVESV以及RVEDV明显低于对照组,脂联素明显高于对照组(P<0.01)。与对照组比较,观察组总有效率更高(94.32%vs 84.09%,P=0.03),MACE发生率略低(2.27%vs 6.82%,P>0.05)。结论老年AMI患者接受丹红注射液联合阿替普酶静脉溶栓治疗,有助于抑制心肌纤维化以及心室重构进程,疗效显著且预后良好。

Objective To study the curative effect of Danhong Injection combined with intravenous ateplase thrombolysis on myocardial fibrosis and ventricular remodeling in elderly AMI patients.Methods One hundred and seventy-six elderly AMI patients admitted to our hospital from June 2017 to September 2018 were randomly divided into control group(n=88)and observation group(n=88).The patients in control group received intravenous ateplase thrombolysis and those in observation group underwent intravenous ateplase thrombolysis with the addition of Danhong Injection.Their serum levels of Gal-3,TGF-β1,CTGF,NF-κB,CysC,adiponectin,MMP-9,FGF-23 were measured.The clinical efficacy and incidence of MACE were recorded in two groups after treatment.Results The serum Gal-3,TGF-β1,CTGF,NF-κB,CysC,MMP-9,FGF-23 levels,the LVRI and LVMI were significantly lower,the RVESV and RVEDV were significantly smaller while the serum adiponectin level was significantly higher in two groups after treatment than before treatment(P<0.05)and in observation group than in control group after treatment(P<0.01).The total effective rate of Danhong Injection combined with intravenous ateplase thrombolysis was significantly higher in observation group than in control group(94.32%vs 84.09%,P=0.03).No significant difference was detected in incidence of MACE between the two groups(2.27%vs 6.82%,P>0.05).Conclusion Danhong Injection combined with intravenous ateplase thrombolysis can inhibit myocardial fibrosis and ventricular remodeling in elderly AMI patients with a significant curative effect and a good outcome.