曲美他嗪联合左卡尼汀对急性心肌梗死PCI后患者血清MPO、sST2及NT-proBNP水平的影响

Influence of trimetazidine combined with levocarnitine on levels of serum myeloperoxidas,soluble suppression of tumorigenicity 2 and N-terminal pro-brain natriuretic peptide in patients with acute myocardial infarction after PCI

目的探究曲美他嗪联合左卡尼汀对急性心肌梗死经皮冠状动脉介入术(PCI)后患者血清髓过氧化物酶(MPO)、可溶性致癌抑制因子2(sST2)及N末端脑钠肽前体(NT-proBNP)水平的影响。方法选取急性心肌梗死患者90例为研究对象且均接受PCI,随机分为观察组和对照组,每组各45例。对照组应用曲美他嗪,观察组在此基础上,围手术期加用左卡尼汀,对比两组的疗效。结果治疗前,两组患者的左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室短轴缩短率(LVFS)、心肌酶指标、MPO、sST2、NT-proBNP等指标均无组间差异(P>0.05)。治疗后,两组的LVEF升高,其余指标均降低,观察组LVEF高于对照组,其余指标均低于对照组,差异有统计学意义(P<0.05)。治疗后观察组肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)指标水平均较对照组降低(P<0.05),且观察组中心力衰竭和再入院发生率均较对照组降低(P<0.05),两组患者急性冠脉综合征及心源性死亡发生率无统计学差异(P>0.05)。结论急性心肌梗死PCI后使用曲美他嗪联合左卡尼汀有助于恢复心功能、减轻心损伤和改善预后。

Objective To study the influence of trimetazidine combined with levocarnitine on levels of serum myeloperoxidas(MPO),soluble suppression of tumorigenicity 2(sST2)and N-terminal pro-brain natriuretic peptide(NT-proBNP)in patients with acute myocardial infarction(AMI)after percutaneous coronary intervention(PCI).Methods AMI patients(n=90)were chosen and given PCI treatment,and they were divided randomly into observation group and control group(each n=45).The control group was treated with trimetazidine,and on the bases of trimetazidine treatment,observation group was treated with levocarnitine during perioperative period.The curative effects were compared between 2 groups.Results Before treatment,the indexes of left ventricular ejection fraction(LVEF),left ventricular end-diastolic inner diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular fraction shortening(LVFS),myocardial enzyme,MPO,sST2 and NT-proBNP had no differences between 2 groups(P>0.05).After treatment,LVEF increased and other indexes decreased in 2 groups,and LVEF was higher and other indexes were lower in observation group than those in control group(P<0.05).After treatment,the levels of creatine kinase(CK),creatine kinase-MB isoenzyme(CK-MB)and lactic dehydrogenase(LDH)decreased(P<0.05),and incidence rates of heart failure and re-hospitalization decreased(P<0.05)in observation group compared with control group.The incidence rates of acute coronary syndrome and cardiac death had no statistical differences between 2 groups(P>0.05).Conclusion Trimetazidine combined with levocarnitine is conducive for recovering heart function,relieving heart damage and improving prognosis in patients with AMI after PCI.