PCI术后应用益气复脉(冻干)对青少年急性心肌梗死患者左心室重构及miR-23a水平的影响  

Effects of Supplementary Application of Yiqi Fumai Injection(Lyophilized)on Left Ventricular Remodeling and miR-23a Levels in Adolescent Patients with Acute Myocardial Infarction

作　　者：赵新祥[1] 苏方成[1] 房师荣[1] 李永光[1] Zhao Xinxiang;Su Fangcheng;Fang Shirong;Li Yongguang(Weifang People's Hospital,Shandong,Weifang 261041,China)

机构地区：[1]山东省潍坊市人民医院,山东潍坊261041

出　　处：《中国中医急症》2023年第1期100-103,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：潍坊市卫生计生委科研项目(wfwsjs_2018_025)。

摘　　要：目的观察青少年急性心肌梗死患者经冠状动脉介入术(PCI)后辅助应用益气复脉(冻干)对其左心室重构以及miR-23a水平的影响。方法选取急诊PCI治疗的13~40岁急性心肌梗死患者52例,随机分为观察组与对照组各26例,均PCI手术后结合常规西医治疗,观察组在此基础上加用益气复脉(冻干)静滴,通过酶联免疫吸附法(ELISA)、心动超声仪和RT-PCR检测两组患者治疗前后外周血中白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-9(MMP-9)的表达水平,左心室舒张末期内径(LVEDD)、后壁厚度(LVPWT)、舒张末期室间隔厚度(IVST)、重量指数(LVMI)、射血分数(LVEF)、舒张末期容积(LVEDV)和收缩末期容积(LVESV)及血清miR-23a水平。同时记录比较两组治疗前后的不良心血管事件发生率。结果治疗后观察组IL-6、TNF-α、MMP-9、LVEDD、LVPWT、IVST、LVMI、LVEDV、LVESV、miR-23a相对表达水平均显著低于对照组(P<0.05),LVEF明显高于对照组(P<0.05),不良心血管事件发生率低于对照组。结论在常规手术和西医治疗基础上加用益气复脉(冻干)能有效抑制青少年急性心肌梗死后炎症反应、心肌细胞外基质降解以及心室重构,改善心功能,降低miR-23a水平,且明显降低不良心血管事件发生率,安全且有较高的临床应用价值。Objective:To investigate the effect of supplementary application of Yiqi Fumai Injection(lyophilized)on left ventricular remodeling and miR-23a levels in adolescent patients with acute myocardial infarction after coronary intervention(PCI).Methods:A total of 52 adolescent patients with acute myocardial infarction between the ages of 13 and 40 were selected and randomly divided into a control group and an observation group,with 26 cases in each group.Combined with conventional western medicine treatment,the observation group was additionally treated with Yiqi Fumai Injection(lyophilized).The levels of interleukin-6(IL-6),tumor necrosis factor-α(TNF-α),matrix metalloproteinase-9(MMP-9)in peripheral blood,and left ventricular end-diastolic diameter(LVEDD),Wall thickness(LVPWT),end-diastolic septal thickness(IVST),weight index(LVMI),ejection fraction(LVEF),end-diastolic volume(LVEDV)and end-systolic volume(LVESV)and the relative expression levels of miR-23a were detected by enzyme-linked immunosorbent assay(ELISA),echocardiography and RT-q PCR.At the same time,the incidence of major adverse cardiovascular events(MACE)was recorded and compared before and after treatment in the two groups.Results:After treatment,the levels of IL-6,TNF-α,MMP-9,LVEDD,LVPWT,IVST,LVMI,LVEDV,LVESV,miR-23a in the observation group were significantly lower than those of the control group,and the LVEF was significantly higher than that of the control group(P<0.05).The MACE of the observation group was lower than that of the control group.Conclusion:On the basis of conventional surgery and western medicine treatment,the addition of Yiqi Fumai Injection(lyophilized)can effectively inhibit the inflammatory response,myocardial extracellular matrix degradation and ventricular remodeling after acute myocardial infarction in adolescents,improve cardiac function,reduce the level of miR-23a,and reduce the incidence of adverse cardiovascular events significantly,which is safe and has high clinical application value.

关 键 词：急性心肌梗死 PCI术 青少年 益气复脉(冻干) 左心室重构 miR-23a 

分 类 号：R542.22[医药卫生—心血管疾病]