左卡尼汀联合重组人脑钠肽对急性心肌梗死经皮冠状动脉介入术后再灌注损伤的影响

Effect of Levocarnitine Combined with Recombinant Human Brain Natriuretic Peptide on Reperfusion Injury after Percutaneous Coronary Intervention for Acute Myocardial Infarction

目的:探究左卡尼汀联合重组人脑钠肽(rhBNP)对急性心肌梗死(AMI)经皮冠状动脉介入(PCI)术后再灌注损伤的影响。方法:选取2021年1月—2022年12月于六盘水市人民医院接受PCI术的AMI患者80例为研究对象,按照随机数字表法分为对照组和观察组,各40例。两组均采用常规PCI治疗,对照组PCI术后立即给予rhBNP,观察组在对照组的基础上采用左卡尼汀治疗。比较两组心肌损伤标志物[肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、心脏脂肪酸结合蛋白(H-FABP)]、左心功能指标[左室舒张末期容量(LVEDV)、左室质量指数(LVMI)、左室射血分数(LVEF)]及不良心血管事件发生率。结果:治疗后,两组CK-MB、cTnI和H-FABP水平低于治疗前,观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组LVMI水平低于治疗前,LVEDV、LVEF水平高于治疗前,观察组LVMI水平低于对照组,LVEDV、LVEF水平高于对照组,差异有统计学意义(P<0.05);观察组不良心血管事件发生率低于对照组,差异有统计学意义(P=0.025)。结论:左卡尼汀联合rhBNP治疗对AMI患者PCI术后心肌再灌注损伤程度有一定的预防效果,可减轻心肌损伤,改善左心室功能,降低不良心血管事件发生率。

Objective:To investigate the effect of levocarnitine combined with recombinant human brain natriuretic peptide(rhBNP)on reperfusion injury after percutaneous coronary intervention(PCI)for acute myocardial infarction(AMI).Methods:Eighty patients with AMI who underwent PCI in Liupanshui People's Hospital from January 2021 to December 2022 were selected for the study,and were divided into a control group and an observation group of forty cases each according to the method of randomized numerical table.Both groups were treated with conventional PCI,the control group was given rhBNP immediately after PCI,and the observation group was treated with levocarnitine on the basis of the control group.Myocardial injury markers[creatine kinase isoenzyme(CK-MB),cardiac troponin I(cTnI),cardiac fatty acid binding protein(H-FABP)],left heart function indexes[left ventricular end-diastolic volume(LVEDV),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF)]and the incidence rate of adverse cardiovascular events were compared between the two groups.Results:After treatment,the levels of CK-MB,cTnI and H-FABP were lower than those before treatment in both groups,and the observation group was lower than the control group,and the difference was statistically significant(P<0.05);after treatment,the levels of LVMI in both groups were lower than before treatment,and the levels of LVEDV and LVEF were higher than before treatment,and the level of LVMI in the observation group was lower than that in the control group,and the levels of LVEDV and LVEF were higher than those in the control group,and the difference was statistically significant(P<0.05);the incidence of adverse cardiovascular events in the observation group was lower than that in the control group,and the difference was statistically significant(P=0.025).Conclusion:Levocarnitine combined with rhBNP treatment has a certain preventive effect on the degree of myocardial reperfusion injury after PCI in AMI patients,which can reduce myocardial injury,improve left ventricular function,and reduce the incidence of adverse cardiovascular events.