麝香保心丸联合沙库巴曲缬沙坦钠治疗急性心肌梗死PCI术后的临床效果
收稿日期: 2024-02-28
网络出版日期: 2025-01-16
基金资助
滁州市卫生健康科研项目(2022009)
Clinical effect of Shexiang Baoxin pill combined with sacubitril/valsartan in the treatment of acute myocardial infarction after percutaneous coronary intervention
Received date: 2024-02-28
Online published: 2025-01-16
目的: 探究麝香保心丸联合沙库巴曲缬沙坦钠治疗急性心肌梗死经皮冠状动脉介入(percutaneous coronary intervention, PCI)治疗术后的临床效果。方法: 选取滁州市第一人民医院2021年1月—2023年11月收治的120例急性心肌梗死PCI术后患者,按随机数字表法分为观察组60例和对照组60例。对照组患者予以抗凝、抗血小板、调脂等常规治疗基础上加用沙库巴曲缬沙坦钠,观察组在常规治疗的基础上加用沙库巴曲缬沙坦钠联合麝香保心丸治疗。比较2组患者治疗前后C反应蛋白(C-reactive protein, CRP)、氨基末端脑利尿钠肽前体(N-terminal pro-brain natriuretic peptide, NT-proBNP)、血压、左室舒张末期内径(left ventricular end-diastolic diameter, LVEDD)、左室收缩末期内径(left ventricular end-systolic diameter, LVESD)、左室短轴缩短率(fractional shortening, FS)、左室射血分数(left ventricular ejection fraction, LVEF),比较2组住院期间心律失常的发生率、住院时间及6个月内因心脏不良事件再住院率。结果: 治疗4周后,观察组患者血清CRP、NT-proBNP水平均较治疗前显著降低(均P<0.05);治疗6个月后,观察组心脏彩色超声指标(LVEDD、LVESD、FS、LVEF)改善优于对照组(均P<0.05);住院期间观察组房性、室性心律失常的发生率低于对照组(均P<0.05),住院时间观察组短于对照组(P<0.05)。随访6个月,再住院率观察组较对照组低(5.1%比26.3%,P<0.05)。结论: 麝香保心丸联合沙库巴曲缬沙坦钠治疗急性心肌梗死PCI术后患者能有效抑制炎症反应,逆转心室重构,改善心功能,减少并发症的发生,改善预后。
方春梅 , 李峰 , 沈童童 , 周扬 . 麝香保心丸联合沙库巴曲缬沙坦钠治疗急性心肌梗死PCI术后的临床效果[J]. 内科理论与实践, 2024 , 19(05) : 310 -313 . DOI: 10.16138/j.1673-6087.2024.05.04
Objective To investigate the clinical effect of Shexiang Baoxin pill combined with sacubitril/valasrtan in the treatment of acute myocardial infarction after percutaneous coronary intervention(PCI).Methods A total of 120 patients with acute myocardial infarction from January 2021 to November 2023 after PCI were selected and randomly assigned to observation group (60 cases) and control group (60 cases) in Chuzhou First People’s Hospital. The patients in both groups were given anticoagulation, antiplatelet, lipid-regulating, and other conventional treatment, while the control group was treated with sacubitril/valsartan, and the observation group was treated with sacubitril/valsartan combined with Shexiang Baoxin pill. The indexes including the changes of C-reactive protein(CRP), N-terminal pro-brain natriuretic peptide (NT-proBNP), blood pressure, left ventricular end-diastolic diameter(LVEDD), left ventricular end-systolic diameter(LVESD), fractional shortening(FS) rate, left ventricular ejection fraction (LVEF) were compared between the two groups. The incidence of arrhythmia and length of stay during hospitalization and the rate of re-hospitalization within six months due to adverse cardiac events were also compared between the two groups. Results After 4-week treatment, the levels of CRP and NT-proBNP in the observation group were significantly lower than those in the control group (all P<0.05). After 6-month treatment, the cardiac color ultrasound ultrasonography indexes (LVEDD, LVESD, FS, LVEF) in the observation group were better than those in the control group (all P<0.05). The incidence of atrial and ventricular arrhythmias in the observation group was lower than that in the control group duration of hospital stay (P<0.05), and length of hospitalization in the observation group was shorter than that in the control group (P<0.05). At the 6-month follow-up, the rate of rehospitalization in the observation group was lower than that in the control group (5.1% vs 26.3%, P<0.05).Conclusions The combination of Shexiang Baoxin pill and sacubitri/valsartan can effectively inhibit inflammatory response, reverse ventricular remodeling, improve cardiac function, reduce complications and improve prognosis in patients with acute myocardial infarction after PCI.
[1] | Tripolt NJ, Kolesnik E, Pferschy PN, et al. Impact of EMpagliflozin on cardiac function and biomarkers of heart failure in patients with acute MYocardial infarction—The EMMY trial[J]. Am Heart J, 2020, 221:39-47. |
[2] | 朱莉军. 麝香保心丸对超高龄心肌梗死患者的治疗效果及预后影响[J]. 中国药物经济学, 2016, 11(11):58-60. |
[3] | 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会, 《中国循环杂志》编辑委员会. 急性心肌梗死诊断和治疗指南[J]. 中国循环杂志, 2001, 16 (6):407-422. |
[4] | 段小春, 王松涛, 严研, 等. 沙库巴曲缬沙坦钠治疗急性心肌梗死后射血分数降低型心力衰竭的临床效果[J]. 中国医药, 2020, 15(12):1827-1830. |
[5] | Sawhney JP. Angiotensine converting enzyme inhibitors in acute myocardial infarction[J]. Indian Heart J, 2011, 63(1):71-78. |
[6] | 黄攀登, 吴远慧, 谷伟, 等. 麝香保心丸联合西药治疗老年急性心肌梗死的临床疗效[J]. 中国循证心血管医学杂志, 2016, 8(9):1096-1099. |
[7] | 中国医师协会胸痛专业委员会, 中华心血管病杂志(网络版)编辑委员会, 急性心肌梗死后心室重构防治专家共识起草组(网络版)编辑委员会. 急性心肌梗死后心室重构防治专家共识[J]. 中华心血管病杂志(网络版), 2020, 3(1):1-7. |
[8] | 李敏, 丁念. 五参汤加减联合常规治疗对急性心肌梗死PCI介入术后患者的临床疗效[J]. 中成药, 2021, 43(7):1968-1970. |
[9] | 姜峰爵. 麝香保心丸联合阿托伐他汀治疗急性心肌梗死的疗效观察[J]. 临床合理用药杂志, 2020, 13(17):54-55. |
[10] | 艾民, 颜昌福, 夏福纯, 等. 血清hs-CRP及VEGF水平对急性心肌梗死经皮冠状动脉介入治疗术后心血管事件的影响[J]. 山东医药, 2018, 58 (1): 16-18. |
[11] | Ong SB, Hernández-Reséndiz S, Crespo-Avilan GE, et al. Inflammation following acute myocardial infarction: multiple players, dynamic roles, and novel therapeutic opportunities[J]. Pharmacol Ther, 2018, 186:73-87. |
[12] | Chang PC, Lin SF, Chu Y, et al. LCZ696 therapy reduces ventricular tachyarrhythmia inducibility in a myocardial infarction-induced heart failure rat model[J]. Cardiovasc Ther, 2019, 2019:6032631. |
[13] | Li LY, Lou Q, Liu GZ, et al. Sacubitril/valsartan attenuates atrial electrical and structural remodelling in a rabbit model of atrial fibrillation[J]. Eur J Pharmacol, 2020, 881:173120. |
[14] | Guo J, Qin Z, He Q, et al. Shexiang baoxin pill for acute myocardial infarction: clinical evidence and molecular mechanism of antioxidative stress[J]. Oxid Med Cell Longev, 2021, 2021:7644648. |
/
〈 |
|
〉 |