单硝酸异山梨酯联合β受体阻滞剂对急性心肌梗死的影响

摘要/Abstract

摘要： 目的探究单硝酸异山梨酯联合β受体阻滞剂对急性心肌梗死患者血清H-FABP、GDF-15水平的影响。方法选取2019年2月~2020年2月期间于河南省义马市人民医院接受治疗的108例急性心肌梗死患者,根据奇偶数分组法将其分为β受体阻滞剂组及联合治疗组,每组54例。β受体阻滞剂组采用β受体阻滞剂进行治疗,联合治疗组在其基础上加服单硝酸异山梨酯进行治疗。检测LVEF、LVEDD、LVPFR、CK、ET-1、NT-proBNP、sICAM-1、IL-6、hs-CRP、GDF-15、H-FABP水平。观察并比较2组患者不良反应发生情况。结果与β受体阻滞剂组相比,联合治疗组LVEF、LVPFR水平较高,LVEDD、心肌梗死标志物、炎性因子、H-FABP、GDF-15水平较低（P<0.05）;联合治疗组总不良反应发生情况高于β受体阻滞剂组（P>0.05）。结论单硝酸异山梨酯联合β受体阻滞剂可有效改善急性心肌梗死患者临床症状,促进心功能恢复正常,降低心肌梗死标志物指标水平,其机制可能与降低H-FABP、GDF-15水平相关。

关键词: 单硝酸异山梨酯, β受体阻滞剂, 急性心肌梗死, 心肌脂肪酸结合蛋白

Abstract: Objective To explore the effect of isosorbide mononitrate combined with β-blocker on the serum levels of H-FABP and GDF-15 in patients with acute myocardial infarction. Methods A total of 108 patients with acute myocardial infarction treated in Yima People's Hospital of Henan Province from February 2019 to February 2020 were selected and divided into β-blocker group and combined treatment group according to odd-even grouping method, with 54 cases in each group. The β-blocker group was treated with β-blockers, and the combination group received isosorbide mononitrate on its basis. The levels of LVEF, LVEDD, LVPFR, CK, ET-1, NT-proBNP, sICAM-1, IL-6, hs-CRP, GDF-15, and H-FABP were measured. The occurrence of adverse reactions between the two groups was observed and compared. Results Compared with the β-blocker group, the combination group had higher level of LVEF, LVPFR, LVEDD, inflammatory factor H-FABP, GDF-15 (P<0.05); the total adverse effects in the combined treatment group were higher than those in the β-blocker group (P>0.05). Conclusion Isosorbide mononitrate combined with β-blockers can effectively improve the clinical symptoms of patients with acute myocardial infarction, promote the return of heart function to normal, and reduce the levels of myocardial infarction markers. The mechanism may be related to the reduction of H-FABP and GDF-15 levels.

Key words: isosorbide mononitrate, β-receptor blocker, acute myocardial infarction, myocardial fatty acid binding protein

中图分类号:

R734.2

刘小丽, 张玉德. 单硝酸异山梨酯联合β受体阻滞剂对急性心肌梗死的影响[J]. 承德医学院学报, 2023, 40(6): 476-480.

LIU Xiao-li, ZHANG Yu-de. Effect of Isosorbide Mononitrate Combined with β-blockers on Acute Myocardial Infarction[J]. Journal of Chengde Medical University, 2023, 40(6): 476-480.

参考文献

[1] Khodayari S, Khodayari H, Amiri AZ, et al.Inflammatory microenvironment of acute myocardial infarction prevents regeneration of heart with stem cells therapy[J]. Cell Physiol Biochem, 2019, 53(5): 887-909.
[2] Allonneau A, Gonzva J, Lovi S, et al.Prise en charge en urgence de l’infarctus du myocarde de la femme Emergency treatment of myocardial infarction in women[J]. Rev Infirm, 2017, 66(233): 20-21.
[3] 刘云顺,栾淑芳,王炯波. 贝那普利对老年急性心肌梗死患者的临床疗效分析[J]. 中国医刊,2020,55(8):850-854.
[4] 谭璐,汪曲,杨峰,等. 阿魏酸钠+参麦注射液方案用于急性心肌梗死辅助治疗的临床价值研究[J]. 海南医学院学报,2018,24(17):1547-1550,1554.
[5] 刘少云,崔松,于娜,等. 瑞舒伐他汀联合环磷腺苷葡胺治疗急性心肌梗死对血清VEGF-B和GDF-15水平的影响[J]. 疑难病杂志,2019,18(12):1195-1199.
[6] 中国医师协会急诊医师分会,国家卫健委能力建设与继续教育中心急诊学专家委员会,中国医疗保健国际交流促进会急诊急救分会. 急性冠脉综合征急诊快速诊治指南(2019)[J]. 中华急诊医学杂志,2019,28(4):421-428.
[7] 刘云顺,栾淑芳,王炯波. 贝那普利对老年急性心肌梗死患者的临床疗效分析[J]. 中国医刊,2020,55(8):850-854.
[8] 张辉. 氯吡格雷联合低分子肝素对急性心肌梗死患者的疗效分析[J]. 检验医学与临床,2020,17(15):2153-2156.
[9] Zhang J, He S, Wang X, et al.Effect of trimetazidine on heart rate variability in elderly patients with acute coronary syndrome[J]. Pak J Med Sci, 2016, 32(1): 75-78.
[10] Heusch G, Gersh BJ.The pathophysiology of acute myocardial infarction and strategies of protection beyond reperfusion: a continual challenge[J]. Eur Heart J, 2017, 38(11): 774-784.
[11] Podlesnikar T, Pizarro G, Fernández-Jiménez R, et al.Effect of early metoprolol during ST-Segment elevation myocardial infarction on Left ventricular strain: Feature-Tracking cardiovascular magnetic resonance substudy From the METOCARD-CNIC trial[J]. JACC Cardiovasc Imaging, 2019, 12(7 Pt 1): 1188-1198.
[12] 邹瑛,孙艳蓉. 法舒地尔联合通心络对高血压急性心肌梗死PCI术后患者血清炎性因子的影响[J]. 现代中西医结合杂志,2018,27(19):2105-2108.
[13] 张琳. 不同剂量阿托伐他汀对急性心肌梗死患者介入治疗后血脂水平及心室重构的影响[J]. 中国临床药理学杂志,2020,36(10):1176-1179.
[14] 王永,胡晴,王永军,等. 硝普钠联合重组人尿激酶原对急性ST段抬高型心肌梗死患者经皮冠状动脉介入后无复流的效果观察[J]. 中国心血管病研究,2020,18(7):643-646.
[15] 范群雄,赵继先,张焕鑫,等. 通心络联合曲美他嗪在急性ST段抬高型心肌梗死经皮冠状动脉介入术后应用对心功能的影响[J]. 海南医学院学报,2017,23(13):1801-1804.
[16] 许明生,张科芝,杨林飞,等. 左卡尼汀对急性心肌梗死急诊PCI患者血清H-FABP及6 MWT的影响[J]. 中国急救医学,2017,37(10):900-902.
[17] 邓超,豆利华. 丹参多酚酸盐对急性心肌梗死溶栓再通患者血清h-FABP、IMA水平的影响[J]. 中国老年学杂志,2011,31(11):2078-2079.
[18] 刘少云,崔松,于娜,等. 瑞舒伐他汀联合环磷腺苷葡胺治疗急性心肌梗死对血清VEGF-B和GDF-15水平的影响[J]. 疑难病杂志,2019,18(12):1195-1199.
[19] 高永红,黎庆伟,杨柳,等. 不同剂量美托洛尔治疗AMI疗效及对心功能、血清CK、CK-MB、Cys-C和GDF-15水平的影响[J]. 检验医学与临床,2019,16(20):3026-3028.