阿托伐他汀钙片联合骨髓间充质干细胞移植治疗心肌梗死的临床研究
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摘要
目的观察阿托伐他汀钙片联合骨髓间充质干细胞移植治疗心肌梗死的临床疗效及安全性。方法将80例心肌梗死患者随机分为对照组40例和试验组40例。对照组予以阿托伐他汀钙每次20 mg,qd,口服,治疗1个月;试验组在对照组治疗的基础上,予以骨髓间充质干细胞移植。观察2组患者的临床疗效、炎症因子水平、心功能及药物不良反应的发生情况。结果治疗后,试验组和对照组的总有效率分别为92.50%(37例/40例)和82.50%(33例/40例),差异有统计学意义(P<0.05)。治疗后,试验组和对照组的肿瘤坏死因子-α分别为(1.36±0.85)和(2.54±0.77)μg·L~(-1),白细胞介素-6分别为(5.28±0.76)和(9.86±1.22)ng·L~(-1),白细胞介素-8分别为(16.38±4.69)和(21.54±5.47)ng·L~(-1),高敏C反应蛋白分别为(3.64±1.08)和(5.74±1.29)mg·L~(-1),左心室舒张末期内径分别为(40.26±5.29)和(45.34±5.20)mm,左心室收缩末期内径分别为(53.36±5.41)和(60.42±5.37)mm,差异均有统计学意义(均P<0.05)。2组患者的药物不良反应均以轻度转氨酶升高为主,试验组和对照组的总药物不良反应发生率分别为7.50%和5.00%,差异无统计学意义(P>0.05)。结论阿托伐他汀钙片联合骨髓间充质干细胞移植治疗心肌梗死的临床疗效显著,其可显著降低患者的炎症因子水平,改善心功能,且不增加药物不良反应的发生率。
Objective To observe the clinical efficacy and safety of atorvastatin calcium tablets combined with bone marrow mesenchymal stem cell transplantation in the treatment of myocardial infarction.Methods Eighty patients with myocardial infarction were randomly divided into control and treatment groups with 40 cases per group. Control group was treated with atorvastatin calcium 20 mg per time,qd,orally,treat for 1 month. Treatment group was treated with bone marrow mesenchymal stem cell transplantation on the basis of the control group. The clinical efficacy,the levels of inflammatory factors,cardiac function and adverse drug reactions were compared between two groups. Results After treatment,the total effective rates of treatment and control groups were92. 50%( 37 cases/40 cases) and 82. 50%( 33 cases/40 cases) with significant difference( P < 0. 05). After treatment,the main indexes in treatment and control groups were compared: tumor necrosis factor alphawere( 1. 36 ± 0. 85) and( 2. 54 ± 0. 77) μg·L~(-1),interleukin-6 were( 5. 28 ± 0. 76) and( 9. 86 ± 1. 22) ng·L~(-1),interleukin-8 were( 16. 38 ± 4. 69) and( 21. 54 ± 5. 47) ng·L~(-1),high sensitivity C-reactive protein were( 3. 64 ± 1. 08) and( 5. 74 ± 1. 29) mg·L~(-1),left ventricular end-diastolic dimension were( 40. 26 ± 5. 29) and( 45. 34 ± 5. 20) mm,left ventricular end-systolic dimension were( 53. 36 ± 5. 41) and( 60. 42 ± 5. 37) mm,the differences were statistically significant( all P < 0. 05). The adverse drug reactions in the two groups were mild transaminase increasing. The incidences of adverse drug reactions in treatment and control groups were 7. 50% and5. 00% without significant difference( P > 0. 05). Conclusion Atorvastatin calcium tablets combined with bone marrow mesenchymal stem cell transplantation have a definitive clinical efficacy in the treatment of myocardial infarction,which can statistically reduce the levels of inflammatory cytokines and improve the heart function,without increasing the incidence of adverse drug reactions.
Objective To observe the clinical efficacy and safety of atorvastatin calcium tablets combined with bone marrow mesenchymal stem cell transplantation in the treatment of myocardial infarction.Methods Eighty patients with myocardial infarction were randomly divided into control and treatment groups with 40 cases per group. Control group was treated with atorvastatin calcium 20 mg per time,qd,orally,treat for 1 month. Treatment group was treated with bone marrow mesenchymal stem cell transplantation on the basis of the control group. The clinical efficacy,the levels of inflammatory factors,cardiac function and adverse drug reactions were compared between two groups. Results After treatment,the total effective rates of treatment and control groups were92. 50%( 37 cases/40 cases) and 82. 50%( 33 cases/40 cases) with significant difference( P < 0. 05). After treatment,the main indexes in treatment and control groups were compared: tumor necrosis factor alphawere( 1. 36 ± 0. 85) and( 2. 54 ± 0. 77) μg·L~(-1),interleukin-6 were( 5. 28 ± 0. 76) and( 9. 86 ± 1. 22) ng·L~(-1),interleukin-8 were( 16. 38 ± 4. 69) and( 21. 54 ± 5. 47) ng·L~(-1),high sensitivity C-reactive protein were( 3. 64 ± 1. 08) and( 5. 74 ± 1. 29) mg·L~(-1),left ventricular end-diastolic dimension were( 40. 26 ± 5. 29) and( 45. 34 ± 5. 20) mm,left ventricular end-systolic dimension were( 53. 36 ± 5. 41) and( 60. 42 ± 5. 37) mm,the differences were statistically significant( all P < 0. 05). The adverse drug reactions in the two groups were mild transaminase increasing. The incidences of adverse drug reactions in treatment and control groups were 7. 50% and5. 00% without significant difference( P > 0. 05). Conclusion Atorvastatin calcium tablets combined with bone marrow mesenchymal stem cell transplantation have a definitive clinical efficacy in the treatment of myocardial infarction,which can statistically reduce the levels of inflammatory cytokines and improve the heart function,without increasing the incidence of adverse drug reactions.
引文
[1]樊留芳,殷泉忠,崔俊友,等.阿托伐他汀对老年慢性心力衰竭患者心功能和相关炎症因子的影响[J].实用老年医学,2015,29(12):1014-1017.
[2]中华医学会心血管病学分会,中华心血管病学杂志编辑委员会,中国心肌病诊断与治疗建议工作组.心肌病诊断与治疗建议[J].中华心血管病杂志,2007,29(1):5-7.
[3]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2010,38(8):675-687.
[2]中华医学会心血管病学分会,中华心血管病学杂志编辑委员会,中国心肌病诊断与治疗建议工作组.心肌病诊断与治疗建议[J].中华心血管病杂志,2007,29(1):5-7.
[3]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.急性ST段抬高型心肌梗死诊断和治疗指南[J].中华心血管病杂志,2010,38(8):675-687.