美托洛尔联合替罗非班对急性心肌梗死的疗效及对血清脂蛋白相关磷脂酶A2、生长分化因子-15、可溶性ST2蛋白的影响

Effect of metoprolol combined with tirofiban on acute myocardial infarction and on serum lipoprotein-associated phospholipase A2,growth differentiation factor-15 and soluble ST2 protein

目的探讨美托洛尔联合替罗非班治疗急性心肌梗死(acute myocardial infarction,AMI)的效果及对血清脂蛋白相关磷脂酶(lipoprotein-associated phospholipase,Lp-PL)A2、生长分化因子(growth differentiation factor,GDF)-15、可溶性ST2蛋白(soluble ST2 protein,sST2)的影响。方法选择2020年1月至2022年6月于盐城市第三人民医院心内科接受治疗的AMI患者165例,采用随机数表法分为试验组(n=83,美托洛尔+替罗非班)和对照组(n=82,美托洛尔)。比较两组临床疗效、血清Lp-PLA2、GDF-15、sST2、心输出量(cardiac output,CO)、每搏量(stroke volume,SV)、左心室射血分数(left ventricular ejection fraction,LVEF)水平、心血管不良事件(cardiovascular adverse events,CVAE)及不良反应发生情况。结果治疗后,试验组总有效率高于对照组(93.98%vs 82.93%),差异有统计学意义(P<0.05)。两组血清Lp-PLA2、GDF-15及sST2水平均随时间推移而降低,且试验组低于对照组,差异有统计学意义(P<0.05)。两组CO、SV及LVEF水平均随时间推移而升高,且试验组高于对照组,差异有统计学意义(P<0.05)。试验组再发心肌梗死、心绞痛、心力衰竭及严重程度低于对照组,差异有统计学意义(P<0.05)。两组用药不良反应发生情况差异无统计学意义(P>0.05)。结论在AMI患者中应用美托洛尔联合替罗非班疗效显著,可有效改善血清Lp-PLA2、GDF-15、sST2水平及心功能。

Objective To investigate the effects of metoprolol combined with tirofiban in the treatment of acute myocardial infarction(AMI)and its effects on serum lipoprotein-associated phospholipase(Lp-PL)A2,growth differentiation factor(GDF)-15 and soluble ST2 protein(sST2).Methods A total 165 patients with AMI who received treatment in the department of cardiology of Yancheng third people's hospital from January 2020 to June 2022 were selected and divided into experimental group(n=83,metoprolol+tirofiban)and control group(n=82,metoprolol)by random number table method.Clinical efficacy,serum Lp-PLA2,GDF-15,sST2,cardiac output(CO),stroke volume(SV),left ventricular ejection fraction(LVEF),cardiovascular adverse events(CVAE)and incidence of adverse reactions were compared between the two groups.Results After treatment,the total effective rate of experimental group was higher than that of control group(93.98%vs 82.93%),the difference was statistically significant(P<0.05).Serum Lp-PLA2,GDF-15 and sST2 levels in two groups were decreased over time,and the experimental group was lower than the control group,the difference was statistically significant(P<0.05).The levels of CO,SV and LVEF in both groups were increased over time,and the experimental group was higher than the control group,the difference was statistically significant(P<0.05).The reoccurrence of MI,angina pectoris,heart failure and its severity in experimental group were lower than those in control group,and the difference were statistically significant(P<0.05).There was no statistical significance in the occurrence of adverse reactions between the two groups(P>0.05).Conclusion Metoprolol combined with tirofiban is effective in AMI patients,which can effectively improve serum Lp-PLA2,GDF-15,sST2 and cardiac function.