钠-葡萄糖协同转运蛋白2抑制剂沙库巴曲缬沙坦钠片分别联合阿托伐他汀治疗心肌梗死的疗效及对血清癌胚抗原和乳脂球表皮生长因子-E8影响

Effect of SGLT2 and Noxital combined with atorvastatin on myocardial infarction and serum CEA and MFG-E8

目的探讨钠-葡萄糖协同转运蛋白2抑制剂(SGLT2)、沙库巴曲缬沙坦钠片分别联合阿托伐他汀治疗心肌梗死的疗效及对血清癌胚抗原(CEA)及乳脂球表皮生长因子-E8(MFG-E8)影响。方法将160例心肌梗死患者根据用药方法不同分为3组,对照组(60例)、观察A组(50例)和观察B组(50例)。对照组介入治疗后采取降压、调脂、抗感染等常规治疗措施,并口服阿司匹林、氯吡格雷。观察A组在对照组基础上应用诺欣妥联合阿托伐他汀治疗,观察B组在对照组基础上应用SGLT2联合阿托伐他汀治疗。对比3组患者治疗总有效率,治疗前后心功能、心肌酶谱变化情况以及不良反应发生率。结果观察A组与观察B组总有效率高于对照组(92%、88%与57%,P<0.05),且观察A组与观察B组对比差异无统计学意义(92%与88%,P>0.05);3组患者治疗前左心室射血分数(LVEF)、左心室收缩末期容积(LVESV)、左心室舒张末期容积(LVEDV)对比差异无统计学意义(P>0.05),治疗后,3组患者LVEF升高,观察B组高于观察A组及对照组(F=3.566,P<0.05),LVESV、LVEDV降低,观察B组低于观察A组及对照组(F=2.133、4.447,P<0.05);3组患者治疗前心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)对比差异无统计学意义(P>0.05),治疗后,3组患者cTnI、CK-MB、CK降低,观察B组低于观察A组及对照组(F=21.807、5.158、5.472,P<0.05);3组患者治疗前CEA、MFG-E8对比差异无统计学意义(P>0.05),治疗后,3组患者MFG-E8升高,观察B组高于观察A组及对照组(F=3.237,P<0.05),CEA降低,观察B组低于观察A组及对照组(F=19.096,P<0.05);3组患者不良反应发生率对比差异无统计学意义(7%与12%与8%,χ^(2)=0.213,P=0.644)。结论对介入治疗后的心肌梗死患者无论是采取诺欣妥联合阿托伐他汀治疗还是SGLT2联合阿托伐他汀均能够提升患者临床疗效,但采取SGLT2联合阿托伐他汀治疗能够进一步提升患者心功能,降低心肌损伤,促进血管重建,降低炎症反应,且安全性较高。

Objective To investigate the efficacy of sodium glucose cotransporter 2 inhibitor(SGLT2)and Noxital combined with atorvastatin in the treatment of myocardial infarction and their effects on serum carcinoem-bryonic antigen(CEA)and lactoglobular epidermal growth factor-E8(MFG-E8).Methods The 160 MI patients were divided into three groups:control group(n=60),observation group A(n=50),and observation group B(n=50).The control group took antihypertensive,lipid-regulating and anti-infection measures,and received oral aspirin and clopidogrel.Observation A with nohaction with atorvastatin on the control group,and group B with SGLT 2 with atorvastatin on the control group.The total response rate,cardiac function,myocardial enzymatic changes before and after treatment,and the incidence of adverse reactions were compared between the three groups.Results The total response rate of the observation group A and the observation group B was higher than that of the control group (92%, 88% vs 57%, P<0.05), and no significant difference between observed group A and observed group B (P>0.05). There was no significant difference in LVEF, LVESV, LVEDV(P>0.05), After treatment, LVEF increased in the three groups, observation group B was higher than observation group A and control group (F=3.566,P<0.05), LVESV and LVEDV decreased, and observation group B was lower than observation group A and control group (F=2.133, 4.447, P<0.05). There was no significant difference in cTnI, CK-MB, and CK before treatment in the three groups (P>0.05). After treatment, cTnI, CK-MB, and CK were decreased in the three groups, and observed group B was lower than observed group A and control group (F=21.807, 5.158, and 5.472, P<0.05). There was no difference between CEA and MFG-E8 in the three groups before treatment (P>0.05). After treatment, MFG-E8 increased in the three groups, observed group B was higher than observed group A and observed group A (F=3.237, P<0.05), and CEA decreased, observation group B was lower than observed group A and control group (F=19.096, P<0.05). There was no difference in adverse effects among the three groups (7%, 12% and 8%, χ^(2)=0.213, P=0.644). Conclusion For patients with myocardial infarction after interventional therapy, whether taking Noxital combined with atorvastatin or SGLT2 combined with atorvastatin can improve the clinical efficacy of patients, but taking SGLT2 combined with atorvastatin can further improve patients′ cardiac function, reduce myocardial injury, promote vascular reconstruction, reduce inflammatory reaction, reduce the incidence of adverse cardiovascular events, and has a higher safety.