艾司洛尔与曲美他嗪联合治疗OMI的疗效

Therapeutic effects of esmolol combined trimetazidine on old myocardial infarction

目的:分析艾司洛尔联合曲美他嗪治疗对陈旧性心肌梗死(OMI)患者血清脑钠肽(BNP)、心肌酶、可溶性致癌抑制因子2(sST2)及五聚素3(PTX3)水平的影响。方法:选择我院收治的96例OMI患者,随机分为曲美他嗪组和联合治疗组(艾司洛尔联合曲美他嗪治疗),每组各48例。治疗3个月后,比较两组患者治疗效果、不良反应及心肌酶[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)]、血清BNP、sST2、PTX3水平。结果:治疗3个月后,与曲美他嗪组比较,联合治疗组总有效率显著提高(60.42%比93.75%),不良反应发生率(18.75%比4.17%)显著降低,P=0.001、0.025;两组心肌酶、血清BNP、sST2及PTX3水平均较治疗前均显著降低,且与曲美他嗪组比较,联合治疗组CK[(160.32±7.96)U/L比(143.67±5.68)U/L]、CK-MB[(14.64±3.15)U/L比(10.24±3.01)U/L]、AST[(28.45±2.06)U/L比(24.62±2.81)U/L]、LDH[(198.73±40.11)U/L比(158.24±31.02)U/L]、BNP[(654.00±221.00)ng/L比(535.00±174.00)ng/L]、sST2[(17.87±3.37)μg/L比(13.26±2.29)μg/L]及PTX3[(0.80±0.14)μg/L比(0.65±0.16)μg/L]水平降低更显著(P均<0.01)。结论:艾司洛尔与曲美他嗪联合治疗OMI能够显著提高疗效,减少不良反应的发生,利于预后。

Objective:To analyze influence of esmolol combined trimetazidine on serum levels of brain natriuretic peptide(BNP),myocardial enzymes,soluble suppression of tumorigenicity 2(sST2)and pentraxin 3(PTX3)in patients with old myocardial infarction(OMI).Methods:A total of 96 OMI patients treated in our hospital were randomly and equally divided into trimetazidine group and combined treatment group(received trimetazidine combined esmolol).After three-month treatment,therapeutic effect,adverse reactions and levels of myocardial enzymes[creatine(CK),creatine kinase(CK-MB),aspartate transaminase(AST),lactate dehydrogenase(LDH)],serum BNP,sST2 and PTX3 were compared between two groups.Results:After three-month treatment,compared with trimetazidine group,there was significant rise in total effective rate(60.42%vs.93.75%)and significant reduction in incidence rate of adverse reaction(18.75%vs.4.17%)in combined treatment group,P=0.001,0.025;compared with before treatment,there were significant reductions in levels of myocardial enzymes,serum BNP,sST2,PTX3 in two groups,compared with trimetazidine group,there were significant reductions in levels of CK[(160.32±7.96)U/L vs.(143.67±5.68)U/L],CK-MB[(14.64±3.15)U/L vs.(10.24±3.01)U/L],AST[(28.45±2.06)U/L vs.(24.62±2.81)U/L],LDH[(198.73±40.11)U/L vs.(158.24±31.02)U/L],serum BNP[(654.00±221.00)ng/L vs.(535.00±174.00)ng/L],sST2[(17.87±3.37)μg/L vs.(13.26±2.29)μg/L]and PTX3[(0.80±0.14)μg/L vs.(0.65±0.16)μg/L]in combined treatment group,P<0.01 all.Conclusion:Esmolol combined trimetazidine can significantly improve therapeutic effect and reduce adverse reactions in OMI patients,and it’s good for prognosis.