心脉隆注射液联合富马酸比索洛尔片治疗急性心肌梗死并发心力衰竭患者的临床效果

Clinical Effect of Xinmerong Injection Combined with Bisoprolol FumarateTablet in the Treatment of Patients with Heart Failure Caused byAcute Myocardial Infarction

目的探讨心脉隆注射液联合富马酸比索洛尔片治疗急性心肌梗死(AMI)并发心力衰竭(HF)患者的效果。方法选取开封市中医院2021年5月至2023年8月收治AMI并发HF患者106例,按随机数表法分为两组,各53例。两组均接受利尿、吸氧、扩血管及强心等对症治疗。对照组接受富马酸比索洛尔片治疗,试验组接受心脉隆注射液联合富马酸比索洛尔片治疗。比较两组临床疗效、安全性及治疗前后心电图参数[平均正常RR间期标准差(SDNN)、相邻RR间期差值>50 ms的百分数(PNN50)、正常RR间期平均值标准差(SDANN)]、炎症因子指标[白细胞介素-6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)]、心肌损伤相关指标[N-末端B型利钠肽原(NT-proBNP)、肌酸激酶同工酶(CK-MB)、基质金属蛋白酶-9(MMP-9)、转化生长因子-β1(TGF-β1)]、生活质量[明尼苏达心力衰竭生活质量量表(MLHFQ)评分]。结果试验组临床总有效率较对照组高(P<0.05);两组不良反应发生率与对照组比较,差异无统计学意义(P>0.05)。重复测量分析显示,两组SDNN、PNN50、SDANN、IL-6、hs-CRP、TNF-α、NT-proBNP、CK-MB、TGF-β1、MMP-9及MLHFQ评分主体内及主体间效应有统计学意义(P<0.05);治疗1周及2周,试验组SDNN、PNN50、SDANN较对照组高,试验组血清IL-6、hs-CRP、TNF-α、NT-proBNP、CK-MB、TGF-β1、MMP-9及MLHFQ评分较对照组低(P<0.05)。结论采用心脉隆注射液联合富马酸比索洛尔片治疗AMI并发HF患者,可有效降低炎症反应,抑制心肌纤维化,减轻心肌损伤,改善心率变异性,进一步提升临床疗效,为较理想的用药方案。

Objective To investigate the efficacy of Xinmailong injection combined with bisoprolol fumarate tablet in the treatment of patients with heart failure(HF)caused by acute myocardial infarction(AMI).Methods A total of 106 patients with HF caused by AMI admitted to Kaifeng Hospital of Traditional Chinese Medicine from May 2021 to August 2023 were selected and divided into two groups by random number table method,53 cases in each group.The control group was treated with bisoprolol fumarate tablet,and the experimental group was treated with Xinmerong injection combined with bisoprolol fumarate tablet.The clinical efficacy,safety and electrocardiograph parameters[mean normal RR interval standard deviation(SDNN),percentage of adjacent RR interval difference>50 ms(PNN50),standard deviation of mean value of normal RR interval(SDANN)],inflammatory factors[interleukin-6(IL-6),hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)],myocardial damage related indicators[N-terminal B-type natriuretic peptide(NT-proBNP),creatine kinase isoenzyme(CK-MB),matrix metalloproteinase-9(MMP-9),transforming growth factor-β1(TGF-β1)],Quality of life[Minnesota heart failure quality of life scale(MLHFQ)score]before and after treatment were compared between the two groups.Results The total effective rate of experimental group was higher than that of control group(P<0.05),and there was no difference in the adverse reaction rate between the two group(P>0.05).Repeated measurement analysis showed that there were statistical differences in the intra-subject and inter-subject effects of SDNN,PNN50,SDANN,IL-6,hs-CRP,TNF-α,NT-proBNP,CK-MB,TGF-β1,MMP-9 and MLHFQ scores between the two groups(P<0.05).After 1 and 2 weeks of treatment,SDNN,PNN50,SDANN in experimental group were higher those of control group,serum levels of IL-6,hs-CRP,TNF-α,NT-proBNP,CK-MB,TGF-β1,MMP-9 and MLHFQ score in experimental group were lower than those in the control group(P<0.05).Conclusion Xinmailong injection combined with bisoprolol fumarate tablets can effectively reduce inflammatory response,inhibit myocardial fibrosis,alleviate myocardial injury,improve heart rate variability,and further enhance clinical efficacy for HF caused by AMI patients.