针刺联合左卡尼汀对心肌梗死伴心律失常患者MMP-9、PⅢNP、Gal-3水平的影响  

Effects of Acupuncture Combined with Levocarnitine on the Levels of MMP-9,PⅢNP,and Gal-3 in Patients with Myocardial Infarction Coupled with Arrhythmia

作　　者：胡智超 赵华云[1] 王文会[1] 芦超兰 HU Zhichao;ZHAO Huayun;WANG Wenhui;LU Chaolan(Foshan Hospital of Traditional Chinese Medicine,Foshan 528000,China;Foshan Women and Children Hospital,Foshan 528000,China)

机构地区：[1]佛山市中医院,佛山528000 [2]佛山市妇幼保健院,佛山528000

出　　处：《上海针灸杂志》2022年第2期111-116,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：广东省中医药局科研项目(20203009)。

摘　　要：目的观察针刺联合左卡尼汀对心肌梗死伴心律失常患者3血清MMP-9、PⅢNP、Gal-3水平的影响。方法将158例心肌梗死伴心律失常患者随机分为对照组和联合组,每组79例。对照组静脉滴注左卡尼汀治疗,联合组在对照组治疗基础上联合针刺治疗。比较两组治疗前后血清基质金属蛋白酶-9(MMP-9)、内皮微颗粒(EMPs)、Ⅲ型前胶原氨基端末肽(PⅢNP)、血管紧张素Ⅱ(AngⅡ)、血浆氨基末端B型利钠肽前体(NT-ProBNP)和半乳糖蛋白3(Gal-3)的水平。比较两组治疗前后左心室收缩功能(LVSF)、左心室射血分数(LVEF)、左心室收缩功能不全(LVSD)和左室舒张功能障碍(LVDD)的水平。比较两组中医证候评分的变化、临床疗效和不良反应发生情况。结果两组治疗后血清MMP-9和EMPs水平均降低(P<0.05),且联合组上述指标均低于对照组(P<0.05)。两组治疗后血清PⅢNP、AngⅡ和NT-ProBNP均低于同组治疗前(P<0.05),血清Gal-3均高于同组治疗前(P<0.05);且联合组治疗后血清PⅢNP、AngⅡ和NT-ProBNP低于对照组,Gal-3高于对照组(P<0.05)。两组治疗后LVSF、LVEF高于同组治疗前(P<0.05),LVSD、LVDD低于同组治疗前(P<0.05);且联合组治疗后LVSF、LVEF高于对照组(P<0.05),LVSD、LVDD低于对照组(P<0.05)。与治疗前比较,两组治疗后中医证候评分均降低(P<0.05),且联合组低于对照组(P<0.05)。联合组总有效率高于对照组(P<0.05)。两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论针刺联合左卡尼汀治疗心肌梗死伴心律失常可改善患者血清MMP-9、PⅢNP和Gal-3水平,提高心功能,缓解临床症状,疗效优于单纯左卡尼汀治疗。Objective To observe the effects of acupuncture plus Levocarnitine on the serum levels of matrix metallopeptidase-9(MMP-9),N-terminal peptide of typeⅢprocollagen(PⅢNP),and galectin-3(Gal-3)in patients with myocardial infarction coupled with arrhythmia.Method A total of 158 patients with myocardial infarction coupled with arrhythmia were randomized into a control group and an integration group,with 79 cases in each group.The control group was treated with intravenous infusion of Levocarnitine,and the integration group was given additional acupuncture treatment.Before and after the treatment,the levels of serum MMP-9,endothelial microparticles(EMPs),PⅢNP,and angiotensinⅡ(AngⅡ),plasma amino-terminal pro-B-type natriuretic peptide(NT-ProBNP),and Gal-3 were compared.The level ventricular systolic function(LVSF),left ventricular ejection fraction(LVEF),left ventricular systolic dysfunction(LVSD),and left ventricular diastolic dysfunction(LVDD)levels in the two groups were compared before and after the treatment.The change in the traditional Chinese medicine(TCM)symptom score,clinical efficacy,and adverse reaction rate were also compared.Result After the treatment,the serum levels of MMP-9 and EMPs dropped in both groups(P<0.05)and were lower in the integration group than in the control group(P<0.05).After the treatment,the serum levels of PⅢNP,AngⅡ,and NT-ProBNP dropped(P<0.05),and the level of serum Gal-3 increased(P<0.05)in the two groups;the serum levels of PⅢNP,AngⅡ,and NT-ProBNP were lower,and the level of serum Gal-3 was higher in the integration group than in the control group(P<0.05).The levels of LVSF and LVEF rose after the treatment in both groups(P<0.05),and the levels of LVSD and LVDD dropped(P<0.05);the levels of LVSF and LVEF were higher in the integration group than in the control group after the treatment(P<0.05),and the levels of LVSD and LVDD were lower(P<0.05).Compared with the baseline,the TCM symptom score decreased after the treatment in the two groups(P<0.05)and was lower in th

关 键 词：针刺疗法 针药并用 心肌梗死 心律失常 基质金属蛋白酶-9 Ⅲ型前胶原氨基端末肽 半乳糖蛋白3 

分 类 号：R246.1[医药卫生—针灸推拿学]