伊伐布雷定联合他汀类药物对经皮冠状动脉介入治疗后患者疗效、心功能、冠状动脉血流、心肌损伤标记物表达的影响

Effect of Ivabradine Combined with Statins on the Expressions of Microrna-126,Microrna-208a and Galectin-3 in Patients after Percutaneous Coronary Intervention

目的探讨伊伐布雷定联合他汀类药物对经皮冠状动脉介入(percutaneous coronary intervention,PCI)治疗后患者疗效、心功能、冠状动脉血流、心肌损伤标记物表达的影响,及对微小RNA(microRNA,miR)-126、miR-208a、半乳糖凝集素-3(Galectin-3)表达水平的影响。方法收集2019年10月至2021年9月保定市第二中心医院收治的158例急性心肌梗死患者为治疗对象,以患者的住院号为分组依据,采用电脑随机抽签分为观察组、对照组,各79例。两组患者均进行PCI治疗,对照组术后给予他汀类药物治疗,观察组术后予伊伐布雷定联合他汀类药物治疗。综合评估两组患者的心功能指标、临床疗效、冠状动脉血流参数、血清学细胞因子水平、治疗安全性等指标。结果治疗后观察组患者的左心室射血分数(left ventricular ejection fraction,LVEF)、心排血量(CO)、心指数(CI)均高于对照组,左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)低于对照组,差异有统计学意义(P<0.05)。治疗后观察组临床总有效率高于对照组,差异有统计学意义(P<0.05)。治疗后观察组患者冠状动脉血流参数包括收缩期峰流速(SPV)、舒张期峰流速(DPV)、舒张期时间速度积分(DTVI)、冠状动脉血流储备(CFVR)均高于对照组,差异有统计学意义(P<0.05)。治疗后观察组患者的miR-126、miR-208a、半乳糖凝集素-3表达水平均低于对照组,差异有统计学意义(P<0.05)。治疗期间观察组、对照组不良反应发生率比较,差异无统计学意义[12.66%(10/79)vs.8.86%(7/79),P>0.05]。结论伊伐布雷定联合他汀类药物对PCI治疗后患者的治疗效果良好,能够改善患者的心功能,增加患者的冠状动脉血流供应,抑制miR-126、miR-208a、半乳糖凝集素-3的表达,未显著增加患者的不良反应发生率。

Objectives To investigate the therapeutic effect of ivabradine combined with statins in patients after percuta⁃neous coronary intervention(PCI)and on expressions of microRNA(miR)-126,mir-208a and galectin-3.Methods Totally 158 patients with acute myocardial infarction treated in Baoding Second Central Hospital from October 2019 to September 2021 were collected as the treatment objects.Based on the hospitalization number of patients,they were randomly divided into observation group and control group by computer lottery,with 79 cases in each group.Both groups were treated with PCI.Control group was treated with statins and observation group was treated with ivabradine combined with statins.The indexes of cardiac function,clinical efficacy,coronary blood flow parameters,serum concentration of cytokine and treatment safety were comprehensively evaluated.Results After treatment,the left ventricular ejection fraction(LVEF),cardiac output(CO)and cardiac index(CI)in observation group were significantly higher than those in control group,and the left ventricular end diastolic diameter(LVEDD)was significantly lower than that in control group(P<0.05).After treatment,the total clinical effective rate of observation group was higher than that of control group,and the difference was statistically significant(P<0.05).After treatment,the coronary blood flow parameters including peak systolic velocity(SPV),peak diastolic velocity(DPV),diastolic time velocity integral(DTVI)and coronary flow reserve(CFVR)in observation group were significantly higher than those in control group(P<0.05).After treatment,the expressions of miR-126,miR-208a and galectin-3 in observation group were significantly lower than those in control group(P<0.05).During the treatment,there was no significant difference of the incidence of adverse reactions between observation group and control group[12.66%(10/79)vs.8.86%(7/79),P>0.05].Conclusions Ivabradine combined with statins has a good therapeutic effect in patients after PCI.It can improve cardiac function,increase coronary blood flow supply,inhibit the expressions of miR-126,mir-208a and galectin-3,and dose not significantly increase the inci⁃dence of adverse reactions.