rhBNP联合法舒地尔对老年急性心肌梗死患者PCI术后心室重构及血清MCP-1、IL-10、sTRAIL水平的影响  

Effect of rhBNP combined with fasudil on ventricular remodeling and serum levels of MCP-1,IL-10 and sTRAIL in elderly patients with acute myocardial infarction underwent PCI

作　　者：任皓楠 邢少帅 田鑫莹 REN Haonan;XING Shaoshuai;TIAN Xinying(Department of Emergency,The Seventh People's Hospital of Zhengzhou,Zhengzhou Henan 450000,China)

机构地区：[1]郑州市第七人民医院急诊科,河南郑州450000

出　　处：《天津药学》2025年第3期282-286,共5页Tianjin Pharmacy

摘　　要：目的探究老年急性心肌梗死(AMI)患者经皮冠状动脉介入治疗(PCI)术后应用重组人脑利钠肽(rhBNP)联合法舒地尔治疗的临床效果。方法采用随机数字表法将郑州市第七人民医院收治的已行PCI术的168例老年AMI患者分为3组,rhBNP组(n=56)采用单独注射rhBNP治疗,法舒地尔组(n=56)采用单独法舒地尔治疗,联合组(n=56)予注射rhBNP联合法舒地尔治疗,3组均治疗3个月,对比3组临床效果。结果联合组疗效(94.64%)较法舒地尔组(78.57%)和rhBNP组(80.36%)更显著(P<0.05);法舒地尔组与rhBNP组疗效比较无明显差异(P>0.05)。治疗后,法舒地尔组、rhBNP组、联合组的左心室射血分数(LVEF)[(43.56±7.30)%、(43.87±7.34)%、(49.44±7.45)%]高于治疗前;左心室舒张期末容积(LVEDV)[(129.05±8.59)mL、(128.24±8.89)mL、(116.70±7.73)mL]低于治疗前(P<0.05);且联合组LVEF高于法舒地尔组和rhBNP组,LVEDV低于法舒地尔组和rhBNP组(P<0.05);法舒地尔组与rhBNP组LVEF、LVEDV比较无明显差异(P>0.05)。联合组心室重构发生率(10.71%)明显低于法舒地尔组(30.36%)、rhBNP组(28.57%)(χ^(2)=7.413,P=0.025);法舒地尔组与rhBNP心室重构情况比较无明显差异(P>0.05)。治疗后,3组单核细胞趋化蛋白-1(MCP-1)、白细胞介素-10(IL-10)、可溶性肿瘤坏死因子相关凋亡诱导配体(sTRAIL)及N-末端脑钠肽前体(NT-proBNP)水平[法舒地尔组:(203.75±61.16)ng/L、(26.03±8.16)ng/L、(477.25±51.71)pg/L、(754.32±138.58)pg/mL,rhBNP组:(202.87±63.34)ng/L,(25.24±7.89)ng/L、(475.58±50.47)pg/L、(752.63±135.20)pg/mL,联合组:(107.44±62.45)ng/L、(9.50±10.13)ng/L、(361.75±45.23)pg/L、(920.31±220.15)pg/mL]低于治疗前(P<0.05);且联合组治疗后MCP-1、IL-10、sTRAIL及NT-proBNP水平低于法舒地尔组和rhBNP组(P<0.05);法舒地尔组与rhBNP组MCP-1、IL-10、sTRAIL及NT-proBNP比较无明显差异(P>0.05)。联合组MACE率(5.36%)低于法舒地尔组(28.57%)和rhBNP组(30.36%),差异明显(P<0.05);法舒地尔组与rhBNObjective To investigate the clinical outcomes of recombinant human brain natriuretic peptide(rhBNP)combined with fasudil in elderly patients with acute myocardial infarction(AMI)underwent percutaneous coronary intervention(PCI).Methods A total of 168 elderly AMI patients who underwent PCI at the Seventh People's Hospital of Zhengzhou were randomly allocated into three groups using a random number table:the rhBNP group(n=56)received rhBNP monotherapy,the fasudil group(n=56)received fasudil alone,and the combination group(n=56)was treated with both rhBNP and fasudil.All groups received treatment for 3 months,and their clinical outcomes were compared.Results The efficacy of the combination group(94.64%)was more significant than those of the fasudil group(78.57%)and rhBNP group(80.36%)(P<0.05);There was no significant difference in efficacy between the fasudil group and the rhBNP group(P>0.05).After treatment,the left ventricular ejection fraction(LVEF)in the three groups[fasudil group:(43.56±7.30)%;rhBNP group:(43.87±7.34)%;combination group:(49.44±7.45)%]was higher than before treatment,and the left ventricular end-diastolic volume(LVEDV)[fasudil group:(129.05±8.59)mL;rhBNP group:(128.24±8.89)mL;combination group:(116.70±7.73)mL]was lower than before treatment;And the LVEF of the combined group was higher than those of the fasudil group and rhBNP group,while the LVEDV was lower than those of the fasudil group and rhBNP group(P<0.05);After treatment,there was no significant difference in LVEF and LVEDV between the fasudil group and the rhBNP group(P>0.05).The incidence of ventricular remodeling in the combined group(10.71%)was significantly lower than those in the fasudil group(30.36%)and rhBNP group(28.57%)(χ^(2)=7.413,P=0.025);There was no significant difference in ventricular remodeling between the fasudil group and rhBNP group(P>0.05).After treatment,the levels of monocyte chemotactic protein 1(MCP-1),interleukin-10(IL-10),soluble TNF-related apoptosis-inducing ligand(sTRAIL)and N-terminal pro-brain natr

关 键 词：老年急性心肌梗死 重组人脑利钠肽 法舒地尔 心功能 

分 类 号：R542.2[医药卫生—心血管疾病]