心脉隆注射液对老年急性心肌梗死后心力衰竭患者心功能及炎症因子、miR-23a水平的影响

Effect of Xinmailong Injection on heart function and levels of inflammatory factors and miR-23a in elderly patients with heart failure after acute myocardial infarction

目的:探讨心脉隆注射液对老年急性心肌梗死(AMI)后心力衰竭患者心功能及炎症因子、miR-23a水平的影响。方法:纳入老年AMI后心力衰竭患者120例,随机分为治疗组和对照组,每组各60例。两组患者均给予常规治疗,治疗组患者在常规治疗基础上给予心脉隆注射液静脉滴注,治疗周期为7 d。治疗前后,检测所有患者的心功能指标[包括左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、每搏输出量(SV)、左心室射血分数(LVEF)]、炎症因子[包括白介素(IL)-6、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)]、N末端脑钠肽前体(NT-proBNP)及外周血miR-23a水平,并采用Pearson相关分析评价患者的miR-23a水平与心功能指标、炎症因子、NT-proBNP水平的相关性。结果:(1)治疗后,两组患者的LVEF、SV水平较治疗前均升高(P<0.05),LVEDD、LVESD水平较治疗前均降低(P<0.05),且治疗组患者的LVEF、SV水平高于对照组(P<0.05),LVEDD、LVESD水平低于对照组(P<0.05)。(2)治疗后,两组患者的IL-6、TNF-α、hs-CRP、NT-proBNP水平较治疗前均明显降低(P<0.05),且治疗组患者的IL-6、TNF-α、hs-CRP、NT-proBNP水平低于对照组(P<0.05)。(3)治疗后,两组患者的外周血miR-23a水平较治疗前均升高(P<0.05),且治疗组患者的外周血miR-23a水平高于对照组(P<0.05)。(4)治疗前,患者的miR-23a水平与IL-6、TNF-α、hs-CRP、NT-proBNP水平呈负相关。结论:与常规疗法相比,心脉隆注射液结合常规疗法治疗老年AMI后心力衰竭患者,能够更好地改善患者的心功能和炎症状态,升高外周血miR-23a的表达水平,具有一定的临床治疗价值。

Objective:To explore the effect of Xinmailong Injection on the heart function and the levels of inflammatory factors and miR-23a in elderly patients with heart failure after acute myocardial infarction(AMI).Methods:A total of 120 elderly patients with heart failure after AMI were included and randomly divided into the treatment group and control group,60 cases in each group. The patients in both groups were treated with routine treatment,and the patients in the treatment group were treated with intravenous drip of Xinmailong Injection on the basis of routine treatment,with a course of 7 days. Before and after treatment,the levels of cardiac function indexes including left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),stroke volume(SV)and left ventricular ejection fraction(LVEF),inflammatory factors including interleukin(IL)-6,tumor necrosis factor-α(TNF-α)and high sensitivity C-reactive protein(hs-CRP),N-terminal pro-brain natriuretic peptide(NT-proBNP)and peripheral blood miR-23a level were detected. The Pearson correlation analysis was used to evaluate the correlation between the miR-23a level and the cardiac function indexes,inflammatory factors and NT-proBNP levels of the patients.Results:(1)After treatment,the levels of LVEF and SV in the two groups were increased compared with those before treatment(P<0.05),the levels of LVEDD and LVESD were decreased compared with those before treatment(P<0.05),and the levels of LVEF and SV in the treatment group were higher than those in the control group(P<0.05),the levels of LVEDD and LVESD were lower than those in the control group(P<0.05).(2)After treatment,the levels of IL-6,TNF-α,hs-CRP and NT-proBNP in the two groups were significantly decreased compared with those before treatment(P<0.05),and the levels of IL-6,TNF-α,hs-CRP and NT-proBNP in the treatment group were lower than those in the control group(P<0.05).(3) After treatment,the levels of peripheral blood miR-23a in both groups were increased compared with those before treatment(P<0.05),and the level of peripheral blood miR-23a in the treatment group was higher than that in the control group(P<0.05).(4)Before treatment,the miR-23a level of the patients was negatively correlated with the levels of IL-6,TNF-α,hs-CRP and NT-proBNP.Conclusion:Compared with conventional therapy,Xinmailong Injection combined with conventional therapy can better improve the cardiac function and inflammatory status,and increase the expression level of peripheral blood miR-23a in treating elderly patients with heart failure after AMI,which has certain clinical treatment value.