小檗碱联合阿托伐他汀对急性冠状动脉综合征患者血清MMP-9、H-FABP、TLR4水平及预后的影响

Effect of berberine combined with atorvastatin on serum MMP-9,H-FABP,TLR4 levels and prognosis of patients with acute coronary syndrome

目的探究急性冠状动脉综合征(ACS)患者采用小檗碱联合阿托伐他汀治疗疗效。方法选择本院2017年1月—2021年6月收治135例ACS患者作为研究对象,按照随机数字表法以近似1:1比例将患者分为2组,对照组(n=67)予阿托伐他汀治疗,研究组(n=68)予小檗碱联合阿托伐他汀。比较2组患者治疗疗效,治疗前后心绞痛情况、人源单核细胞Toll样受体4(TLR4)mRNA、转录因子-κB(NF-kB)mRNA水平、血清炎症指标、心肌损伤指标、治疗期间不良反应发生情况、预后情况。结果研究组患者总有效率明显高于对照组(P<0.05);2组患者治疗后心绞痛发作次数与持续时间显著低于治疗前(P<0.05),研究组患者治疗后心绞痛发作次数与持续时间显著低于对照组(P<0.05);2组患者治疗后TLR4 mRNA、NF-kB mRNA水平,血清炎症指标、心肌损伤指标明显低于治疗前(P<0.05),研究组患者治疗后TLR4 mRNA、NF-kB mRNA水平、白介素(IL)-1β、基质金属蛋白酶9(MMP-9)、肿瘤坏死因子-α(TNF-α)等血清炎症指标水平,肌酸激酶同功酶(CK-MB)、心型脂肪酸结合蛋白(H-FABP)、肌钙蛋白I(cTnI)等血清心肌损伤指标水平显著低于对照组(P<0.05);研究组与对照组患者治疗期间不良反应发生率,差异无统计学意义(P>0.02);研究组患者预后不良发生率明显低于对照组(P<0.05)。结论ACS患者采用小檗碱联合阿托伐他汀可以经由下调血清MMP-9、H-FABP、TLR4水平提高治疗疗效,患者预后情况优异。

Objective To explore the curative effect of berberine combined with atorvastatin in the treatment of patients with acute coronary syndrome(ACS).Methods A total of 135 patients with ACS admitted to the hospital were selected as the research subjects between January 2017 and June 2021.According to random number table method,the patients were divided into control group(n=67,atorvastatin)and study group(n=68,berberine combined with atorvastatin).Curative effect,angina pectoris,levels of human monocyte Toll-like receptor 4(TLR4)mRNA and transcription factor-κB(NF-κB)mRNA,serum inflammation indexes and myocardial injury indexes before and after treatment,the occurrence of adverse reactions during treatment and prognosis were compared between the two groups.Results The total response rate in study group was significantly higher than that in the control group(P<0.05).After treatment,the attack frequency and duration of angina pectoris were significantly reduced in the two groups(P<0.05).Meanwhile,the attack frequency and duration of angina pectoris in the study group were significantly lower than those in the control group(P<0.05).After treatment,levels of TLR4 mRNA and NF-κB mRNA,serum inflammation indexes and myocardial injury indexes in both groups were significantly decreased(P<0.05).The levels of TLR4 mRNA,NF-kB mRNA,interleukin(IL)-1β,matrix metalloproteinase-9(MMP-9),tumor necrosis factor-α(TNF-α),creatine kinase MB(CK-MB),heart type fatty acid binding protein(H-FABP)and cardiac troponin I(cTnI)in study group were significantly lower than those in control group(P<0.05).The difference in incidence of adverse reactions during treatment between study group and control group was not statistically significant(P>0.02).The incidence of poor prognosis in study group was significantly lower than that in control group(P<0.05).Conclusion The application of berberine combined with atorvastatin in ACS patients can improve curative effect by decreasing serum MMP-9,H-FABP and TLR4 levels,with good prognosis.