Zhang Zhenpeng,Li Jun,Liu Yongmei,et al.The clinical study of Salvianolate with intervention bioinformatics of patients with Non-ST-segment elevation myocardial infarction[J].,2021,43(01):27-31.[doi:10.3760/cma.j.cn115398-20200311-00111]
丹参多酚酸盐干预急性非ST段抬高型心肌梗死生物标志物研究
- Title:
- The clinical study of Salvianolate with intervention bioinformatics of patients with Non-ST-segment elevation myocardial infarction
- 关键词:
- 非ST段抬高型心肌梗塞; 活血化瘀药; 注射用丹参多酚酸盐; 生物标志物
- Keywords:
- Non-ST elevated myocardial infarction; Promoting blood circulation and removing blood stasis drugs; Salvianolic acid injection; Biomarkers
- 摘要:
- 目的 观察丹参多酚酸盐干预后急性非ST段抬高型心肌梗死(non-ST segment elevation myocardial infarction, NSTEMI)患者生物标志物的变化。方法 将符合入选标准的2016年1月－2019年12月本院81例NSTEMI患者采用随机数字表法分为2组，治疗过程中，2组各脱落6例，最终对照组34；例、治疗组35例完成研究。对照组采用西医常规疗法治疗，治疗组在对照组基础上静脉滴注0.9%氯化钠注射液250 ml＋注射用丹参多酚酸盐。2组均连续治疗10 d。采用胶乳免疫比浊法检测超敏C反应蛋白(high sensitivity CRP, hs-CRP)，采用双抗夹心免疫化学发光法检测降钙素原(procalcitonin, PCT)、电化学发光法检测N末端B型利钠肽原(N-terminal pro-B-type natriuretic peptide, NT-proBNP)、凝固法检测血浆纤维蛋白原(fibrinogen, FIB)、免疫分析法检测D-二聚体。记录并采集患者住院期间(0～10 d)梗死后心绞痛发作次数，以及院内急性心力衰竭、院内再发心肌梗死、院内恶性心律失常、院内死亡等心血管不良事件。结果 治疗后，治疗组hs-CRP[(2.46±1.76)mg/L比(3.45±0.67)mg/L，t＝2.324]、PCT[(0.52±0.30)ng/L比(0.11±0.08)ng/L，t＝2.059]、FIB[(1.30±0.63)g/L比(1.97±0.67)g/L，t＝2.168]水平均低于对照组(P＜0.05)，NT-proBNP和D-二聚体水平具有下降趋势，但组内及组间比较，差异无统计学意义(P＞0.05)。住院期间，治疗组梗死后心绞痛发作次数低于对照组(t＝4.019，P＝0.045)；院内急性心力衰竭发生率，以及院内再发心肌梗死、恶性心律失常和院内死亡的发生率组间比较，差异无统计学意义(P＞0.05)。结论 丹参多酚酸盐可在单纯西药治疗基础上降低NSTEMI患者的炎症反应，缓解高凝状态，减少梗死后心绞痛发作次数。
- Abstract:
- Objective To observe the changes of biomarkers in patients with non-ST segment elevation myocardial infarction (NSTEMI) after intervention with Salvianolate. Methods A total 81 patients with NSTEMI who met the inclusion criteria from January 2016 to December 2019 were randomly divided into two groups. The control group dropped 6 cases, the treatment group dropped 6 cases, and finally each group had 35 cases. The control group was treated with conventional medicine therapy, and the treatment group was treated by intravenous drip of 0.9% NS 250 ml + Salvianolate on the basis of the control group. Both groups were treated continuously for 10 days. The latex immunoturbidimetric method was used to detect hypersensitive-C- Reactive-Protein (hs-CRP), double antibodysandwich immune chemiluminescence method for procalcitonin (PCT), electrochemiluminescence method for N-Terminal pro-B-type Natriuretic Peptide (NT-proBNP), coagulation method for plasma fibrinogen (FIB), and immunoassay for D-dimer. The number of episodes of angina pectoris after infarction, recurring myocardial infarction, malignant arrhythmia, and death in the hospital were recorded and collected during the hospitalization period (0-10 d). Results After treatment, hs-CRP (2.46 ± 1.76 mg/L vs. 3.45 ± 0.67 mg/L, t=2.324), PCT (0.52 ± 0.30 ng/L vs. 0.11 ± 0.08 ng/L, t=2.059), FIB (1.30 ± 0.63 g/L vs. 1.97 ± 0.67 g/L, t=2.168) in the treatment group were significantly lower than those in the control group (P<0.05). After treatment, the level of NT-proBNP and D-dimer showed a downward trend, but there was no statistically significant difference within and between groups (P>0.05). During hospitalization, the number of angina pectoris after infarction in the treatment group was significantly lower than that of the control group (t=4.019, P=0.045), while the incidence of acute heart failure, recurring myocardial infarction, malignant arrhythmia and death in the hospital showed no significant difference (P>0.05). Conclusion Salvianolate can reduce the inflammatory response of NSTEMI patients on the basis of western medicine, relieve the hypercoagulable state, and reduce the number of angina pectoris after infarction.
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备注/Memo
通信作者：王阶，Email: Wangjie0103@126.com 基金项目：国家自然科学基金(81673847)
更新日期/Last Update:
2021-01-05