银杏叶片联合阿替普酶静脉溶栓对老年急性心肌梗死病人心室重构及斑块稳定性的影响  

Influence of Ginkgo Biloba Leaf Combined with Intravenous Thrombolysis by Alteplase on Ventricular Remodeling and Plaque Stability in Elderly Patients with Acute Myocardial Infarction

作　　者：冯莉莉[1] 王朝华 李贺[1] 张臣 FENG Lili;WANG Chaohua;LI He;ZHANG Chen(Brain Hospital of Hunan Province,Changsha 410007,Hunan,China)

机构地区：[1]湖南省脑科医院,长沙410007

出　　处：《中西医结合心脑血管病杂志》2021年第3期384-388,共5页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：湖南省自然科学基金(No.2019JJ80026)。

摘　　要：目的探究银杏叶片联合阿替普酶静脉溶栓对老年急性心肌梗死(AMI)病人心室重构及斑块稳定性的影响。方法选取2018年5月—2019年8月于我院收治的老年AMI病人129例,根据随机数字表法将病人分为对照组(63例)及治疗组(66例)。对照组仅接受阿替普酶静脉溶栓治疗,在此基础上,治疗组加用银杏叶片口服治疗。比较两组临床疗效,观察记录治疗期间所发生的不良反应,同时于治疗前后采用酶联免疫吸附法(ELISA)测定血清成纤维细胞生长因子23(FGF23)、基质金属蛋白酶-9(MMP-9)、胱抑素C(Cys C)、核转录因子κB(NF-κB)等心室重构生化指标,检测组织蛋白酶K(Cat K)、凝集素样氧化低密度脂蛋白受体-1(Lox-1)、P选择素等斑块稳定性指标水平,并于相应时点行多普勒超声检查右心室舒张末期容积(RVEDV)、右心室收缩末期容积(RVESV)、左心室质量指数(LVMI)、左心室重构指数(LVRI)等指标,以测定心室重构参数水平。结果治疗组临床疗效明显高于对照组(95.45%与82.54%,χ2=5.40,P=0.02);治疗后,两组RVEDV、RVESV、LVMI、LVRI以及FGF23、MMP-9、Cys C、NF-κB均出现降低,且治疗组较对照组更低(P<0.01);两组Cat K、Lox-1、P选择素均出现降低,且治疗组较对照组更低(P<0.01);同时,两组不良反应发生率比较差异无统计学意义(P>0.05)。结论银杏叶片联合阿替普酶静脉溶栓可明显下调老年AMI病人斑块稳定性指标,且能够有效抑制心室重构进程,临床疗效较好,且安全性高。Objective To explore the influence of ginkgo biloba leaf combined with intravenous thrombolysis by alteplase on ventricular remodeling and plaque stability in elderly patients with acute myocardial infarction.Methods One hundred and twenty-nineelderly patients with acute myocardial infarction from May 2018 to August 2019 were randomly divided into the control group(n=63)and the treatment group(n=65).The control group was treated with intravenous thrombolysis by ateplase,and the treatment group was treated with ginkgo biloba leaf combined with intravenous thrombolysis by alteplase.The clinical efficacy,and adverse reactions during treatment were compared between the two groups.Fibroblast growth factor 23(FGF23),matrix metalloproteinase 9(MMP-9),cystatin C(CysC),nuclear factorκB(NF-κB)and other ventricular remodeling parameters,the levels of cathepsin K(Cat K),lectin-like oxidized low density lipoprotein receptor-1(Lox-1),P-selectin to determine index of plaque stability were measured by enzyme-linked immunosorbent assay(ELISA).The index of ventricular remodeling parameters,including right ventricular end-diastolic volume(RVEDV),right ventricular end-systolic volume(RVESV),left ventricular mass index(LVMI),and left ventricular remodeling index(LVRI)were performed by Doppler ultrasonography.Results The clinical efficacy of the treatment group was significantly higher than that of the control group(95.45%vs 82.54%,χ2=5.40,P=0.02).After treatment,RVEDV,RVESV,LVMI,LVRI,fibroblast growth factor 23,MMP-9,CysC,and NF-κB in both groups were decreased,and RVEDV,RVESV,LVMI,LVRI,fibroblast growth factor 23,MMP-9,CysC,and NF-κB in the treatment group were lower than those in the control group.The levels of Cat K,Lox-1 and P-selectin in both groups were decreased,and the levels of Cat K,Lox-1 and P-selectin in the treatment group were lower than those in the control group(P<0.01).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Ginkgo biloba leaf combined w

关 键 词：急性心肌梗死 银杏叶片 阿替普酶 静脉溶栓 心室重构 斑块稳定性 

分 类 号：R54[医药卫生—心血管疾病]