麝香保心丸联合瑞替普酶治疗急性心肌梗死的效果及对血清miR-208a、miR-208b表达的影响  

Effect of Shexiang Baoxin Pill(麝香保心丸)Combined with Reteplase in Treatment of Acute Myocardial Infarction and Its Effect on Expressions of Serum miR-208a and miR-208b

作　　者：吕秋[1] 郇心乐 甘艳[1] LYU Qiu;YING Xinle;GAN Yan(Department of Cardiovascular Medicine,928th Hospital of The Joint Logistics Support Force of The Chinese People's Liberation Army,Haikou 571100,Hainan,China;Department of Neurosurgery,The Second Naval Hospital of The Southern Theater,Sanya 572000,Hain n,China)

机构地区：[1]中国人民解放军联勤保障部队第928医院,海南海口571100 [2]南部战区海军第二医院,海南三亚572000

出　　处：《中华中医药学刊》2023年第6期74-77,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家中医药管理局科研课题计划项目(2018ZX0128)。

摘　　要：目的探讨麝香保心丸联合瑞替普酶治疗急性心肌梗死(Acute myocardial infarction,AMI)的效果及对血清miR-208a、miR-208b表达的影响。方法采用前瞻性随机对照研究方法选择2019年8月—2021年5月医院AMI患者108例,以计算机生成的随机数字表将患者分为联合组(54例)、对照组(54例)。常规治疗基础上,对照组给予瑞替普酶,联合组给予麝香保心丸联合瑞替普酶,均治疗2周。对比两组疗效与治疗前、治疗2周后心功能[左室舒张末期容积(Left ventricular end-diastolic volume,LVEDV)、左室收缩末期容积(Left ventricular end-systolic volume,LVESV)、左室射血分数(Left ventricular ejection fraction,LVEF)]、血清氧化应激指标[超氧化物歧化酶(Superoxide dismutase,SOD)、丙二醛(Malonaldehyde,MDA)]、miR-208a、miR-208b、血液流变学指标(血浆黏度、全血黏度低切、全血黏度高切)水平,统计两组治疗期间主要心血管不良事件(Majoradverse cardiac events,MACE)发生率。结果经治疗,联合组总有效率(92.59%,50/54)高于对照组(75.93%,41/54)(P<0.05);两组治疗2周后LVEDV、LVESV水平较治疗前降低,且联合组低于对照组,LVEF水平较治疗前升高,且联合组高于对照组(P<0.05);两组治疗2周后血清SOD较治疗前增高,且联合组高于对照组,血清MDA、miR-208a、miR-208b与血浆黏度、全血黏度低切、全血黏度高切水平较治疗前降低,且联合组低于对照组(P<0.05);治疗期间,联合组MACE发生率(5.56%,3/54)低于对照组(18.52%,10/54)(P<0.05)。结论应用麝香保心丸联合瑞替普酶治疗AMI可提升心功能,减轻氧化应激反应,改善血液流变学情况,降低miR-208a、miR-208b水平,减少治疗期间MACE发生,疗效显著。Objective To investigate the effect of Shexiang Baoxin Pill(麝香保心丸)combined with reteplase in the treatment of acute myocardial infarction(AMI)and its effect on expressions of serum miR-208a and miR-208b.Methods A prospective randomized controlled study was used to select 108 patients with AMI in the hospital from August 2019 to May 2021.The patients were divided into a combined group(54 cases)and a control group(54 cases)using a computer-generated random number ta⁃ble.On the basis of conventional treatment,the control group was given reteplase and the combination group was given Shexiang Baoxin Pill combined with reteplase.Both were treated for 2 weeks.The efficacy,cardiac function[left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),left ventricular ejection fraction(LVEF)],serum oxidative stress indicators[superoxide dismutase(SOD),malondialdehyde(MDA)],miR-208a,miR-208b,the levels of hemorheology indicators(plasma viscosity,low viscosity of whole blood,high viscosity of whole blood)before and after 2 weeks of treatment of the two groups were compared.The incidence of majoradverse cardiac events(MACE)during the treatment of two treatment groups was counted.Results After treatment,the total effective rate of the combined group was 92.59%(52/54),higher than that(75.93%,41/54)of the control group(P<0.05).After 2 weeks of treatment,the levels of LVEDV and LVESV in the two groups were lower than those before treatment,and levels of the combined group were lower than those of the control group.LVEF levels were higher than those before treatment,and level of the combined group was higher than that of the control group(P<0.05).After 2 weeks of treatment,the serum SOD levels of the two groups were higher than those before treatment,and level of the combined group was higher than that of the control group.The levels of serum MDA,miR-208a,miR-208b and plasma vis⁃cosity,low-cut of whole blood viscosity,high-cut of whole blood viscosity were lower than those before treatment

关 键 词：麝香保心丸 瑞替普酶 急性心肌梗死 miR-208a miR-208b 

分 类 号：R259.422.2[医药卫生—中西医结合]