麝香保心丸配合重组人脑利钠肽治疗轻中度急性心肌梗死

Shexiang Baoxin Pills Combined with Recombinant Human Brain Natriuretic Peptide in the Treatment of Acute Myocardial Infarction

目的:探讨麝香保心丸配合重组人脑利钠肽治疗轻中度急性心肌梗死患者的临床疗效。方法:选取2020年9月至2021年5月重庆市璧山区人民医院收治的急性心肌梗死(AMI)患者(心功能Killip分级为Ⅰ级或Ⅱ级)110例作为研究对象。按照随机数字表法分为对照组和观察组,每组55例。对照组选用重组人脑利钠肽进行治疗,观察组在对照组的基础上加用麝香保心丸联合治疗。比较2组患者治疗前后的临床疗效、血脂水平、炎症介质水平[高敏C反应蛋白(hs-CRP)、白细胞介素-8(IL-8)、肿瘤坏死因子-α(TNF-α)水平]、心功能指标、血管内皮功能、血管再通率和出血发生率情况。结果:与对照组比较,观察组治疗总有效率更高(P<0.05);与对照组比较,观察组的血管再通率更高、出血发生率更低(P<0.05);治疗后,与治疗前比较,观察组血脂水平、hs-CRP、TNF-α、IL-8水平均明显下降(P<0.05)。2组患者的左心室射血分数(LVEF)、左心室高峰充盈率(LVPFR)、一氧化氮(NO)水平较治疗前升高,左室舒张末期内径(LVEDD)、内皮素-1(ET-1)水平较治疗前降低,观察组的LVEF、LVPFR、NO水平显著高于对照组,而LVEDD、ET-1水平则更低(P<0.05)。结论:麝香保心丸配合重组人脑利钠肽治疗轻中度急性心肌梗死患者效果显著,有一定的临床应用价值,可进一步研究和推广。

Objective:To observe the clinical effect of Shexiang Baoxin Pills combined with recombinant human brain natriuretic peptide on patients with mild to moderate acute myocardial infarction(AMI).Methods:A total of 110 patients with AMI,whose cardiac function Killip grade was GradeⅠor GradeⅡ,were selected and divided into a control group and an observation group according to the random number table,with 55 cases in each group.The control group was treated with recombinant human brain natriuretic peptide,and the observation group was treated with Shexiang Baoxin Pills based on the control group.The clinical efficacy,blood lipid levels,and inflammatory factor levels[high-sensitivity C-reactive protein(hs-CRP),interleukin-8(IL-8),and tumor necrosis factor-α(TNF-α)],cardiac function indexes,vascular endothelial function,vascular recanalization rate,and incidence of bleeding were compared between the two groups before and after treatment.Results:As compared with the control group,the total effective rate of the observation group was higher(P<0.05).As compared with the control group,the blood vessel recanalization rate in the observation group was higher and the bleeding rate was lower(P<0.05).After treatment,the levels of blood lipid,hs-CRP,TNF-α,and IL-8 in the observation group decreased significantly(P<0.05).The levels of left ventricular ejection fraction(LVEF),left ventricular peak filling rate(LVPFR),and nitric oxide(NO)in the two groups were higher than those before treatment,while the levels of LVEDD and ET-1 were lower than those before treatment.The levels of LVEF,LVPFR and NO in the observation group were significantly higher than those in the control group,while the levels of left ventricular end diastolic diameter(LVEDD)and endothelin-1(ET-1)were lower(P<0.05).Conclusion:Shexiang Baoxin Pills combined with recombinant human brain natriuretic peptide have a significant effect on the treatment of patients with mild to moderate AMI and have certain clinical application value,which can be further studied and promoted.