艾司洛尔联合曲美他嗪对急性心肌梗死患者心功能的影响

Effect of esmolol combined with trimetazidine on cardiac function in patients with acute myocardial infarction

目的研究艾司洛尔联合曲美他嗪对急性心肌梗死患者心功能的影响。方法86例急性心肌梗死患者,随机分为对照组和治疗组,每组43例。对照组患者采用盐酸曲美他嗪片治疗,治疗组患者采用盐酸曲美他嗪片联合盐酸艾司洛尔注射液治疗。比较两组患者的临床疗效,治疗前后的心功能指标[左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)]及血清N末端B型钠尿肽前体(NT-proBNP)、可溶性致癌抑制因子2(sST2)、五聚素3(PTX3)水平。结果治疗组患者的临床治疗总有效率为95.35%,高于对照组的72.09%,差异具有统计学意义(P<0.05)。治疗后,两组患者的LVEF均较本组治疗前升高,LVEDD、LVESD均较本组治疗前减小,且治疗组患者的LVEF(43.68±4.59)%高于对照组的(40.22±4.27)%,LVEDD(49.46±3.97)mm、LVESD(40.42±3.72)mm小于对照组的(53.66±3.67)、(43.42±3.23)mm,差异均具有统计学意义(P<0.05)。治疗后,两组患者的血清NT-proBNP、sST2、PTX3水平均较本组治疗前降低,且治疗组患者的血清NT-proBNP(332.75±53.96)ng/L、sST2(13.27±2.32)μg/L、PTX3(0.65±0.16)μg/L均低于对照组的(761.33±92.65)ng/L、(17.91±3.42)μg/L、(0.78±0.14)μg/L,差异均具有统计学意义(P<0.05)。结论艾司洛尔联合曲美他嗪可有效缓解急性心肌梗死患者的临床症状,改善心功能,减轻心肌细胞损伤,保护心肌细胞。

Objective To study the effect of esmolol combined with trimetazidine on cardiac function in patients with acute myocardial infarction.Methods A total of 86 patients with acute myocardial infarction were randomly divided into control group and treatment group,with 43 cases in each group.The control group was treated with trimetazidine dihydrochloride tablets,and the treatment group was treated with trimetazidine dihydrochloride tablets and esmolol hydrochloride injection.The clinical efficacy,cardiac function indicators[left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD)],N-terminal pro-B-type natriuretic peptide(NT-proBNP),soluble suppression of tumorigenicity 2(sST2),pentraxin 3(PTX3)were compared between the two groups.Results The total effective rate of the treatment group was 95.35%,which was higher than 72.09%of the control group,and the difference was statistically significant(P<0.05).After treatment,the LVEF of the two groups were higher than those before treatment,and the LVEDD and LVESD were lower than those before treatment;the LVEF(43.68±4.59)%of the treatment group was higher than(40.22±4.27)%of the control group,and LVEDD(49.46±3.97)mm and LVESD(40.42±3.72)mm were lower than(53.66±3.67)and(43.42±3.23)mm of the control group.All the difference was statistically significant(P<0.05).After treatment,the levels of NT-proBNP,sST2 and PTX3 of the two groups were lower than those before treatment,the NT-proBNP(332.75±53.96)ng/L,sST2(13.27±2.32)μg/L and PTX3(0.65±0.16)μg/L of the treatment group were lower than(761.33±92.65)ng/L,(17.91±3.42)μg/L and(0.78±0.14)μg/L of the control group,and the difference was statistically significant(P<0.05).Conclusion Combination of esmolol and trimetazidine can effectively improve the clinical symptoms of patients with acute myocardial infarction,improve the cardiac function,alleviate cardiomyocyte injury and protect cardiomyocytes in patients with acute myocardial infarction.