黄蛭口服液抑制急性心肌梗死后心肌纤维化的临床观察

Clinical effect of Huangzhi Oral Liquid in inhibiting myocardial fibrosis after acute myocardial infarction

目的探讨黄蛭口服液抑制急性心肌梗死后心肌纤维化的临床效果。方法选择中山市中医院心血管内科2020年3月至2021年9月收治的80例急性心肌梗死后心肌纤维化患者展开研究。根据随机数表法分为观察组和对照组各40例,两组患者均行经皮冠状动脉介入治疗(PCI),术后均按指南推荐给予规范冠心病二级预防方案,对照组采用依那普利口服治疗,观察组在此基础上给予黄蛭口服液治疗,两组患者的疗程均为6周。比较两组患者的临床疗效、治疗前及治疗6周后的血清可溶性ST2(soluble ST2,sST2)、N端B型钠尿肽原(NTpro-BNP)水平和左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左室短轴缩短率(FS)的变化,并记录两组患者在治疗期间的不良反应发生情况。结果观察组患者的治疗总有效率为95.00%,明显高于对照组的80.00%,差异有统计学意义(P<0.05);治疗后,两组患者的血清sST2、NTpro-BNP、LVEDD、LVESD水平较治疗前均明显降低,LVEF较治疗前明显升高,且观察组患者的血清sST2、、NTpro-BNP、LVEDD、LVESD分别为(35.51±9.14)pg/mL、(182.60±50.44)ng/L、(45.43±2.18)mm、(30.41±3.05)mm,明显低于对照组的(70.26±13.05)pg/mL、(230.75±40.90)ng/L、(50.10±2.20)mm、(36.23±3.10)mm,FS为(30.50±3.15)%,明显高于对照组的(26.13±2.91)%,差异均具有统计学意义(P<0.05);治疗期间,观察组患者的不良反应发生率为7.50%,略低于对照组的17.50%,但差异无统计学意义(P>0.05)。结论黄蛭口服液能抑制急性心肌梗死患者心肌纤维化,且能改善患者心肌重塑和心功能,降低心衰发生率,值得临床中推广。

Objective To investigate the clinical effect of Huangzhi Oral Liquid on myocardial fibrosis after acute myocardial infarction.Methods Eighty patients with myocardial fibrosis after acute myocardial infarction in Department of Cardiovascular Medicine,Zhongshan Hospital of Traditional Chinese Medicine from March 2020 to September 2021 were selected as objects.According to the random number table method,they were divided into an observation group and a control group,with 40 patients in each group.All patients underwent percutaneous coronary intervention(PCI),and secondary prevention of coronary heart disease was recommended according to the guidelines after operation.The patients in control group was treated with enalapril orally,and patients in observation group was additionally given Huangzhi Oral Liquid on the basis of the control group.The course of treatment for both groups was 6 weeks.The clinical efficacy,the levels of serum soluble ST2(sST2),N-terminal pro-B-type natriuretic peptide(NTpro-BNP),and the changes of left ventricular end-diastolic diameter(LVEDD),and left ventricular end systolic diameter(LVESD),left ventricular fractional shortening(FS)before treatment and 6 weeks after treatment were compared between the two groups.The adverse reactions of the two groups during treatment were recorded.Results The total effective rate in the observation group was 95.00%,which was significantly higher than 80.00%in the control group(P<0.05).After treatment,the levels of serum sST2,NTpro-BNP,LVEDD,and LVESD levels of the two groups were significantly lower than those before treatment,and FS levels was significantly higher than that before treatment;while the levels of serum sST2,NTpro-BNP,LVEDD,and LVESD in the observation group were(35.51±9.14)pg/mL,(182.60±50.44)ng/L,(45.43±2.18)mm,(30.41±3.05)mm,which were significantly lower than(70.26±13.05)pg/mL,(230.75±40.90)ng/L,(50.10±2.20)mm,(36.23±3.10)mm in the control group,and the level of FS in the observation group was(30.50±3.15)%,significantly higher than(26.13±2.91)%in the control group(P<0.05).During the treatment,the incidence of adverse reactions in the observation group was 7.50%,which was slightly lower than 17.50%in the control group,but the difference was not statistically significant(P>0.05).Conclusion Huangzhi Oral Liquid can inhibit myocardial fibrosis in patients with acute myocardial infarction,improve myocardial remodeling and cardiac function,and reduce the incidence of heart failure,which is worthy of clinical promotion.