芪苈强心胶囊对ST段抬高型心肌梗死预后影响的临床研究

Clinical study on effect of Qili Qiangxin capsules on the prognosis in patients with ST-segment elevation myocardial

目的探讨芪苈强心胶囊(QLQX)对ST段抬高型心肌梗死(STEMI)预后的影响。方法回顾性收集2020年1月—2022年1月在河北医科大学附属平安医院诊治STEMI患者的临床资料,根据治疗方案分为QLQX组和非QLQX组。随访1年,主要观察终点为30 d和1年时主要心脑血管不良事件(MACCEs);次要观察终点为30d和1年时心源性死亡、心肌再梗死、紧急冠状动脉血管重建术、卒中、大出血发生率,30d时的严重STEMI并发症和1年时因心力衰竭再住院治疗、全因死亡发生情况。结果共纳入210例STEMI患者(QLQX组125例,非QLQX组85例)。单因素或KaplanMeier分析显示,QLQX组患者30 d和1年时MACCEs、心源性死亡,30 d时恶性心律失常,1年时心肌再梗死、因心力衰竭再住院治疗和全因死亡发生率等指标均明显低于非QLQX组(P<0.05),而2组其余终点事件发生率差异无统计学意义(P>0.05)。此外,QLQX可能是STEMI患者MACCEs发生的保护因素[30 d:HR=0.157,95%CI(0.032,0.756),P=0.021;1年:HR=0.208,95%CI(0.087,0.497),P=0.014]。结论QLQX辅助治疗有可能改善STEMI患者的MACCEs。

Objective To explore the prognostic impact of Qili Qiangxin capsules(QLQX)in patients with ST-segment elevation myocardial infarction(STEMI).Methods Retrospective collecting the clinical data of STEMI patients treated at PingAn Hospital affiliated to Hebei Medical University from January 2020 to January 2022,divided into QLQX group and non-QLQX group according to treatment plan.Follow-up patients for 1 year,with the main endpoint being major adverse cardiovascular and cerebrovascular events(MACCEs)at 30 d and 1 year;The secondary endpoints were cardiogenic death,myocardial reinfarction,emergency coronary revascularization,stroke,and major bleeding at 30 d and 1 year,as well as severe STEMI complications(30 d),re-admission due to heart failure(1 year),and allcause mortality(1 year).Results A total of 210 STEMI patients were included(125 in the QLQX group and 85 in the non QLQX group).Univariate or Kaplan Meier analysis showed that the MACCE,cardiogenic death,malignant arrhythmia at 30 d,myocardial reinfarction,re-admission due to heart failure,and all-cause mortality rates in the QLQX group were significantly lower than those in the non QLQX group at 30 d and 1 year(P<0.05),while there were no significant differences in the incidence of other observed endpoint events between the two groups(P>0.05).In addition,QLQX may be a protective factor for MACCEs in STEMI patients(30 d:HR=0.157,95%CI 0.032 to 0.756,P=0.021;1 year:HR=0.208,95%CI 0.087 to 0.497,P=0.014).Conclusion QLQX adjuvant therapy may improve MACCEs in STEMI patients.