心脉隆联合艾司洛尔对急性心肌梗死患者左室功能指标和炎症水平的影响

Effects of Xinmailong combined with esmolol on left ventricular function and inflammation level of patients with acute myocardial infarction

目的 观察心脉隆联合艾司洛尔对急性心肌梗死(AMI)患者左室功能指标、炎症水平的影响.方法 选择2017年1月至2019年4月九江市第一人民医院收治的AMI患者102例,将患者按治疗方法不同分为对照组和观察组,每组51例.所有患者均接受常规治疗,对照组加用艾司洛尔注射液(先静脉注射0.25~0.5 mg/kg,然后从0.05 mg·kg^-1·min^-1开始,逐渐增加至0.2 mg·kg^-1·min^-1,维持24 h)进行治疗;观察组在对照组基础上静脉滴注(静滴)心脉隆注射液(6 mL+100 mL 50%葡萄糖溶液,每日1次);两组均连续治疗1周.观察两组患者中医症状积分、左心室功能指标[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室射血分数(LVEF)和每搏量(SV)]、炎症因子水平[血清同型半胱氨酸(Hcy)水平、β2微球蛋白(β2-MG)]以及治疗期间不良心血管事件发生情况.结果 两组治疗后中医症状积分均较治疗前明显降低;巨观察组治疗后中医症状积分明显低于对照组(分:4.13±1.18比8.56±3.62,P<0.05).两组治疗后LVEDD、LVESD、β2-MG、Hcy均较治疗前明显降低,LVEF、SV均较治疗前明显升高(均P<0.05);巨观察组治疗后LVEDD、LVESD、β2-MG、Hcy均明显低于对照组[LVEDD(mm):52.86±5.12比55.67±3.92,LVESD(mm):40.57±6.22比42.16±6.68,β2-MG(mg/L):3.32±0.83比4.39±1.14,Hcy(mg/L):16.22±3.54比22.17±6.38,均P<0.05],LVEF、SV明显高于对照组[LVEF:0.55±0.07比0.47±0.07,SV(mm):18.85±2.17比17.09±2.21, P<0.05].两组治疗期间均未出现显著不良心血管事件.结论 心脉隆联合艾司洛尔治疗AMI患者疗效显著,能使患者左心室功能得以明显改善,并能够显著减轻患者炎症反应,巨用药安全,在临床上的应用价值较高.

Objective To observe the effect of Xinmailong combined with esmolol on left ventricular function and inflammatory level in patients with acute myocardial infarction(AMI).Methods Totally 102 patients with AMI in Jiujiang First People's Hospital from January 2017 to April 2019 were selected and divided into two groups according to different treatment modes,with 51 cases in each group.All patients received routine treatment,the patients in control group were given Esmolol Injection(intravenous injection of 0.25-0.5 mg/kg,and then from 0.05 mg·kg^-1·min^-1,gradually increased to 0.2 mg·kg^-1·min^-1,maintained for 24 hours),and the patients in observation group were given intravenous drip of propafenone(6 mL+100 mL 50%glucose injection,once a day)on the basis of the control group.In both groups the treatment was continued for one week.The traditional Chinese medicine(TCM)symptom score,left ventricular function indexes[left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD),left ventricular ejection fraction(LVEF),stroke volume(SV),inflammatory factor levels[homocysteine(Hcy),β2-microglobulin(β2-MG)]and adverse cardiovascular events between the two groups during treatment were observed.Results The TCM symptom scores after treatment of the two groups were significantly lower than those before treatment,and the TCM symptom score of the observation group was significantly lower than that of the control group(4.13±1.18 vs.8.56±3.62,P<0.05).The LVEDD,LVESD,β2-MG and Hcy of the two groups after treatment were significantly lower than those before treatment,and the LVEF and SV were significantly higher than those before treatment(all P<0.05).The LVEDD,LVESD,β2-MG and Hcy in the observation group after treatment were significantly lower than those in the control group[LVEDD(mm):52.86±5.12 vs.55.67±3.92,LVESD(mm):40.57±6.22 vs.42.16±6.68,β2-MG(mg/L):3.32±0.83 vs.4.39±1.14,Hcy(mg/L):16.22±3.54 vs.22.17±6.38,all P<0.05],and the LVEF and SV were significantly higher than those in the control group[LVEF:0.55±0.07 vs.0.47±0.07,SV(mm):18.85±2.17 vs.17.09±2.21,both P<0.05].There were no significant adverse cardiovascular events in the two groups.Conclusion The therapeutic effect of Xinmailong combined with esmolol on AMI is significant,which can significantly improve the left ventricular function and reduce the inflammatory response of patients,and the drug is safe,with high clinical application value.