银杏叶片结合替格瑞洛对急性心肌梗死疗效及心室重构影响探究  

Effect of Ginkgo Biloba Tablet Combined With Ticagrelor on Ventricular Remodeling in Patients with Acute Myocardial Infarction

作　　者：王颖超[1] 李洪香 苏晓灵[1] WANG Yingchao;LI Hongxiang;SU Xiaoling(Qinghai Provincial People's Hospital,Xining 810001,Qinghai,China)

机构地区：[1]青海省人民医院,青海西宁810001

出　　处：《中华中医药学刊》2023年第1期250-254,共5页Chinese Archives of Traditional Chinese Medicine

基　　金：青海省卫生健康系统指导性计划项目(2021-wjzdx-09)。

摘　　要：目的观察银杏叶片结合替格瑞洛对急性心肌梗死患者疗效及心室重构影响。方法研究纳入93例急性心肌梗死患者(2019年8月—2020年6月收治),以随机数字表法分成参照组46例,观察组47例,观察组患者采取银杏叶片结合替格瑞洛治疗,参照组患者采取替格瑞洛治疗,数据观察:临床疗效、治疗前后中医证候(胸闷刺痛、胸部闷窒、心悸出汗、气短、倦怠懒言等)积分变化、并发症、治疗前后超声心室重构参数变化及心室重构生化指标变化、斑块稳定性指标变化、血清白细胞介素-6(interleukin 6,IL-6)及血浆型脑肽钠(brain natriuretic peptide,BNP)水平变化、不良反应、随访6个月,了解两组患者心脑血管事件发生率。结果观察组患者总有效率为93.62%(44/47),参照组为78.26%(36/46),观察组更高(P<0.05);观察组患者总并发症率为4.26%(2/47),参照组为17.39%(8/46),观察组更低(P<0.05);治疗前,两组患者中医证候(胸闷刺痛、胸部闷窒、心悸出汗、气短、倦怠懒言等)积分、左心室质量指数(left ventricular mass index,LVMI)及左心室重构指数(left ventricular remodeling index,LVRI)、右心室收缩末期容积(right ventricular end-systolic volume,RVESV)及右心室舒张末期容积(right ventricular end-diastolic volume,RVEDV)等超声心室重构参数、血清纤维细胞生长因子23(fibroblast growth factor,FGF23)及胱抑素C(cystatin C,CysC)、基质金属蛋白酶-9(matrix metalloproteinase-9,MMP-9)及核转录因子кB(nuclear factor B,NF-кB)等心室重构生化指标、P选择素、组织蛋白酶K(Cathepsins K,CatK)及凝集素样氧化低密度脂蛋白受体-1(human lectin like oxidized low density lipoprotein receptor 1,lox-1)等斑块稳定性指标、IL-6及BNP水平比较,P>0.05,治疗后两组患者中医证候(胸闷刺痛、胸部闷窒、心悸出汗、气短、倦怠懒言等)积分、LVMI、LVRI、RVESV、RVEDV、FGF23、CysC、MMP-9、NF-кB、P选择素、CatK、lox-1、IL-6�Objective To observe the effect of Ginkgo Biloba Tablet combined with ticagrelor on acute myocardial infarction and ventricular remodeling.Methods In this study,93 patients with acute myocardial infarction admitted from August 2019 to June 2020 were included.The patients were divided into the reference group(46 cases)and the observation group(47 cases)by random number table method.The observation group was treated with Ginkgo Biloba Tablet combined with ticagrelor,and the reference group was treated with ticagrelor.The clinical curative effect and TCM syndrome(chest tightness,tingling,chest stuffiness,palpitations,sweating,shortness of breath,tiredness,laziness,etc)before and after the treatment,the changes,complications,changes of ventricular remodeling parameters,biochemical indexes of ventricular remodeling and plaque stability before and after treatment,changes of serum interleukin-6(IL-6)and plasma brain natride(BNP)and adverse reactions were compared.After 6 months follow-up,the incidence of cardiovascular and cerebrovascular events in two groups was investigated.Results The total effective rate was 93.62%(44/47)in the observation group and 78.26%(36/46)in the reference group and the rate of the reference group was higher than that in the observation group(P<0.05).The total complication rate was 4.26%(2/47)in the observation group and 17.39%(8/46)in the reference group and the rate of the reference group was lower than that in the observation group(P<0.05).Before treatment,two groups’TCM syndromes(chest tightness,tingling,chest stuffiness,palpitations,sweating,shortness of breath,tiredness,laziness,etc),ultrasonic ventricular remodeling parameters such as left ventricular mass index(LVMI),left ventricular remodeling index(LVRI),right ventricular end systolic volume(RVESV)and right ventricular end diastolic volume(RVEDV),ultrasonic ventricular reconstruction parameters,such as serum fiber cell growth factor(23 FGF23),cystatin C(CysC),matrix metalloproteinase-9(MMP-9),nuclear transcription factor kB(NF-KB)a

关 键 词：急性心肌梗死 银杏叶片 替格瑞洛 疗效 中医证候积分 心室重构 心脑血管事件发生率 

分 类 号：R259.422.2[医药卫生—中西医结合]