愈梗通瘀汤治疗急性心肌梗死患者的疗效及对其血流动力学、心肌损伤标志物水平的影响  

Curative Effect of Yugeng Tongyu Decoction on Patients with Acute Myocardial Infarction and Its Influence on Hemodynamics and Myocardial Injury Markers

作　　者：毋领娟 李爱琴[1] 赵鹏[1] 宰娇娇 柴文文 郭鹏 索森森 郭军霞[2] WU Ling-juan;LI Ai-qin;ZHAO Peng;ZAI Jiao-jiao;CHAI Wen-wen;GUO Peng;SUO Sen-sen;GUO Jun-xia(Jiaozuo People′s Hospital,Jiaozuo Henan 454000;The First Affiliated Hospital of Xinxiang Medical College,Xinxiang Henan 453100)

机构地区：[1]焦作市人民医院,河南焦作454000 [2]新乡医学院第一附属医院,河南新乡453100

出　　处：《世界中西医结合杂志》2024年第6期1177-1181,1186,共6页World Journal of Integrated Traditional and Western Medicine

基　　金：河南省科技攻关联合共建项目(LHGJ20190435)。

摘　　要：目的观察愈梗通瘀汤对急性心肌梗死(Acute myocardial infarction,AMI)患者的疗效及对其血流动力学、心肌损伤标志物水平的影响。方法选取2021年5月—2022年5月期间焦作市人民医院收治的AMI患者108例,根据简单随机化法分为对照组和联合组,每组各54例。对照组予常规对症治疗,联合组在常规对症治疗基础上给予愈梗通瘀汤治疗,均治疗14 d。观察比较两组患者治疗效果及治疗前、治疗14 d后炎症因子[肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)、白细胞介素-1β(Interleukin-1β,IL-1β)-1β、白细胞介素-6(Interleukin-6,IL-6)]、血流动力学指标[心输出量(Cardiac output,CO)、每博输出量(Stroke volume,SV)和心脏指数(Cardiac index,CI)]、心肌损伤标志物[心肌肌钙蛋白I(Cardiac troponin I,cTnI)、心型脂肪酸结合蛋白(Heart type fatty acid binding protein,H-FABP)和肌酸激酶同工酶(Creatine kinase isoenzyme,CK-MB)],分析两组患者随访6个月终点事件发生情况。结果治疗后联合组总有效率92.59%(50/54)明显高于对照组77.78%(42/54),差异有统计学意义(P<0.05)。治疗后两组患者炎症因子TNF-α、IL-1β、IL-6水平均较治疗前降低,差异有统计学意义(P<0.05);且联合组炎症因子TNF-α、IL-1β、IL-6水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者血流动力学CO、SV、CI指标均较治疗前升高,差异有统计学意义(P<0.05);且联合组血流动力学CO、SV、CI指标均明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者心肌损伤标志物cTnI、H-FABP、CK-MB水平均较治疗前降低,差异有统计学意义(P<0.05);且联合组心肌损伤标志物cTnI、H-FABP、CK-MB水平均明显低于对照组,差异有统计学意义(P<0.05)。随访6个月期间,联合组脑卒中和再住院发生率低于对照组,差异有统计学意义(P<0.05);两组患者非致死性心肌梗死、心血管死亡、再次血运重建发生率比较,Objective To observe the curative effect of Yugeng Tongyu Decoction on patients with acute myocardial infarction(AMI)and its influence on hemodynamics and myocardial injury markers.Methods A total of 108 AMI patients treated in Jiaozuo People's Hospital from May 2021 to May 2022 were selected as the study objects,and they were divided into a control group and a combined group according to a simple randomization method,with 54 cases in each group.The control group was given conventional symptomatic treatment,and the combined group was given Yugeng Tongyu Decoction on the basis of the conventional symptomatic treatment.Both groups were treated for 14 days.The therapeutic effects of the two groups were compared,as well as inflammatory factors[tumor necrosis factor-nflammatory factors(tumor necroand IL-6)],hemodynamic indicators[cardiac output(CO),stroke volume(SV),and cardiac index(CI)],and markers of myocardial injury[cardiac troponin I(cTnI),heart type fatty acid binding protein(H-FABP),and creatine kinase isoenzyme(CK-MB)]after treatment of 14 days.The occurrence of outcome events in the two groups was analyzed after six months of follow-up.Results After treatment,the total effective rate of the combined group was 92.59%(50/54),higher than that of the control group 77.78%(42/54),and the difference was statistically significant(P<0.05).After treatment,the inflammatory factors TNF-lammator,and IL-6 were decreased in the two groups(P<0.05),and those in the combined group were lower than the control group(P<0.05).After treatment,the hemodynamic indexes CO,SV,and CI in the two groups were higher(P<0.05),and those in the combined group were higher than the control group(P<0.05).After treatment,the myocardial injury markers cTnI,H-FABP,and CK-MB in the two groups were decreased(P<0.05),and those in the combined group were lower than the control group(P<0.05).During the 6-month follow-up,the incidence of stroke and re-hospitalization in the combined group was lower than that in the control group(P<0.05).There was no sign

关 键 词：愈梗通瘀汤 急性心肌梗死 炎症因子 血流动力学 心肌损伤 

分 类 号：R542.22[医药卫生—心血管疾病]