血必净注射液对急性非ST段抬高型心肌梗死患者cTnT、NT-ProBNP、TNF-α、IL-6、IL-10和hs-CRP的影响
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摘要
目的探讨血必净注射液对急性非ST段抬高型心肌梗死(ANSTEMI)患者肌钙蛋白(c Tn) T、N端前脑钠肽(NT-ProBNP)、肿瘤坏死因子(TNF)-α、白细胞介素(IL)-6、IL-10和超敏C反应蛋白(hs-CRP)的影响。方法选择90例AN-STEMI患者,随机分为治疗组和对照组各45例;两组均给予低盐低脂饮食、吸氧、卧床、抗凝、抗血小板聚集、β受体阻滞、降脂、钙离子拮抗剂、血管紧张素受体阻断剂(ARB)或血管紧张素转化酶抑制剂(ACEI)类等药物;治疗组加血必净注射液50 ml,静脉滴注2次/d。入院12 h内及入院治疗第7天早晨抽取c Tn T、NT-ProBNP、TNF-α、IL-6、IL-10和hs-CRP。比较两组治疗前后TNF-α、c Tn T、IL-10、IL-6、NT-ProBNP和hs-CRP的变化。结果治疗后,治疗组TNF-α、c Tn T、IL-6、NT-ProBNP和hs-CRP水平明显降低,IL-10水平明显升高,且改善程度明显优于对照组(均P<0. 05)。结论血必净注射液可以降低ANSTEMI患者血清炎症因子水平,抑制炎症反应,减少心肌细胞损伤,改善心功能,安全可靠,疗效确切。
Objective To treat acute non-ST-segment elevation myocardial infarction( NSTEMI) with Xuebijing injection andobserve the changes of c Tn T,NT-ProBNP,TNF-α,IL-6,IL-10 and hs-CRP. Methods Ninety NSTEMI patients hospitalized wererandomly divided into treatment group and control group with 45 cases in each group from February 2016 to October 2017. Cases in bothgroups were given low-salt and low-fat diet,oxygen inhalation,bed rest,anticoagulation,anti-platelet aggregation,beta receptor block-ade,lipid-lowering,calcium antagonists,ARB or ACEI drugs. In the treatment group,Xuebijing injection was added 50 ml and intra-venous drip twice a day. c Tn T,NT-ProBNP,TNF-α,IL-6,IL-10 and hs-CRP were extracted within 12 hours of admission and fromthe morning of the 7 th day of treatment. The changes of TNF-α,c Tn T,IL-10,IL-6,NT-ProBNP and hs-CRP were compared betweenthe two groups before and after treatment. Results After treatment,the levels of TNF-α,c Tn T,IL-6,NT-ProBNP and hs-CRP in thetreatment group were significantly decreased,while the level of IL-10 was significantly increased,and the improvements were signifi-cantly better than those in the control group( all P<0.05). Conclusions Xuebijing injection could reduce the level of serum inflam-matory factors,inhibit the inflammatory reaction,reduce myocardial cell damage,improve cardiac function in patients with NSTEMI,and the effect is safe,reliable and effective.
Objective To treat acute non-ST-segment elevation myocardial infarction( NSTEMI) with Xuebijing injection andobserve the changes of c Tn T,NT-ProBNP,TNF-α,IL-6,IL-10 and hs-CRP. Methods Ninety NSTEMI patients hospitalized wererandomly divided into treatment group and control group with 45 cases in each group from February 2016 to October 2017. Cases in bothgroups were given low-salt and low-fat diet,oxygen inhalation,bed rest,anticoagulation,anti-platelet aggregation,beta receptor block-ade,lipid-lowering,calcium antagonists,ARB or ACEI drugs. In the treatment group,Xuebijing injection was added 50 ml and intra-venous drip twice a day. c Tn T,NT-ProBNP,TNF-α,IL-6,IL-10 and hs-CRP were extracted within 12 hours of admission and fromthe morning of the 7 th day of treatment. The changes of TNF-α,c Tn T,IL-10,IL-6,NT-ProBNP and hs-CRP were compared betweenthe two groups before and after treatment. Results After treatment,the levels of TNF-α,c Tn T,IL-6,NT-ProBNP and hs-CRP in thetreatment group were significantly decreased,while the level of IL-10 was significantly increased,and the improvements were signifi-cantly better than those in the control group( all P<0.05). Conclusions Xuebijing injection could reduce the level of serum inflam-matory factors,inhibit the inflammatory reaction,reduce myocardial cell damage,improve cardiac function in patients with NSTEMI,and the effect is safe,reliable and effective.
引文
1陈伟伟,高润霖,刘力生,等.中国心血管病报告2015概要[J].中国循环杂志,2016;31(6):521-8.
2李文杰,陈次滨,卢雄.血清C-反应蛋白对急性心肌梗死患者预后的价值[J].河北医药,2005;27(1):35-6.
3胡波,叶少雄,陈忠诚,等.急性心肌梗死患者IL-8、IL-10和TNF-α的水平变化及意[J].中国现代医学杂志,2006;16(7):1052-4.
4贾红旦,鲍仕慧.血必净注射液对脓毒血症患者炎症因子及超敏C-反应蛋白的影响[J].实用预防医学,2014;1(5):609-11.
5中华医学会心血管病学分会.不稳定心绞痛及非ST段抬高型心肌梗死诊断与治疗指南[J].中华心血管病杂志,2007;35(4):295-304.
6华玉淑,谢兴宇,谢毅,等.血必净注射液治疗老龄非ST段抬高急性冠脉综合征36例报告[J].吉林大学学报(医学版),2009;35(5):185.
7 Lopes RD,Gharacholou SM,Holmes DN,et al.Cumulative incidence of death and rehospitalization among the el-derly in the first year after NSTEMI[J].Am J Med,2015;128(6):582-90.
8 Milosevic A,Vasiljevic Pokrajcic Z,Milasinovic D,et al.Immediate versus delayed invasive intervention for non-STEMI patients:the RID-DLE-NSTEMI Study[J].JACC Cardiovasc Interv,2016;9(6):541-9.
9 Navarese EP,Gurbel PA,Andreotti F,et al.Optimal timing of coronary invasive strategy in non ST segment elevation acute coronary syndromes:a systematic review and meta-analysis[J].Ann Intern Med,2013;158(4):261-70.
10 Feldman AM,Mc Namara DM.Medical progress:myocarditis[J].NEngl J Med,2000;343(19):1388-98.
11 Kavsak PA,Don Wauchope AC,Hill SA,et al.Acceptable analytical variation may exceed high-sensitivity cardiac troponin I cutoffs in early rule-out and rule-in acute myocardial infarction algorithms[J].Clin Chem,2016;26(6):90-3.
12 Nestelberger T,Wildi K,Boeddinghaus J,et al.Characterization of the observe zone of the ESC 2015 high-sensitivity cardiac troponin0h/1h-algorithm for the early diagnosis of acute myocardial infarction[J].Int J Cordial,2016;207(8):238-45.
13曹书华,高红梅,王勇强,等.肝移植术后多器官功能障碍综合征中西医结合治疗的临床研究[J].中国中西医结合急救杂志,2002;9(5):263-6.
14 Wang HL,Xing SY,Dong PS,et al.Safety and efficacy of intracoronary tirofiban administration in patients with serious thrombus burden and ST-elevation myocardial infarction undergoing percutaneous coronary intervention[J].Eur Rev Med Pharmacol,2014;18(23):3690-5.
2李文杰,陈次滨,卢雄.血清C-反应蛋白对急性心肌梗死患者预后的价值[J].河北医药,2005;27(1):35-6.
3胡波,叶少雄,陈忠诚,等.急性心肌梗死患者IL-8、IL-10和TNF-α的水平变化及意[J].中国现代医学杂志,2006;16(7):1052-4.
4贾红旦,鲍仕慧.血必净注射液对脓毒血症患者炎症因子及超敏C-反应蛋白的影响[J].实用预防医学,2014;1(5):609-11.
5中华医学会心血管病学分会.不稳定心绞痛及非ST段抬高型心肌梗死诊断与治疗指南[J].中华心血管病杂志,2007;35(4):295-304.
6华玉淑,谢兴宇,谢毅,等.血必净注射液治疗老龄非ST段抬高急性冠脉综合征36例报告[J].吉林大学学报(医学版),2009;35(5):185.
7 Lopes RD,Gharacholou SM,Holmes DN,et al.Cumulative incidence of death and rehospitalization among the el-derly in the first year after NSTEMI[J].Am J Med,2015;128(6):582-90.
8 Milosevic A,Vasiljevic Pokrajcic Z,Milasinovic D,et al.Immediate versus delayed invasive intervention for non-STEMI patients:the RID-DLE-NSTEMI Study[J].JACC Cardiovasc Interv,2016;9(6):541-9.
9 Navarese EP,Gurbel PA,Andreotti F,et al.Optimal timing of coronary invasive strategy in non ST segment elevation acute coronary syndromes:a systematic review and meta-analysis[J].Ann Intern Med,2013;158(4):261-70.
10 Feldman AM,Mc Namara DM.Medical progress:myocarditis[J].NEngl J Med,2000;343(19):1388-98.
11 Kavsak PA,Don Wauchope AC,Hill SA,et al.Acceptable analytical variation may exceed high-sensitivity cardiac troponin I cutoffs in early rule-out and rule-in acute myocardial infarction algorithms[J].Clin Chem,2016;26(6):90-3.
12 Nestelberger T,Wildi K,Boeddinghaus J,et al.Characterization of the observe zone of the ESC 2015 high-sensitivity cardiac troponin0h/1h-algorithm for the early diagnosis of acute myocardial infarction[J].Int J Cordial,2016;207(8):238-45.
13曹书华,高红梅,王勇强,等.肝移植术后多器官功能障碍综合征中西医结合治疗的临床研究[J].中国中西医结合急救杂志,2002;9(5):263-6.
14 Wang HL,Xing SY,Dong PS,et al.Safety and efficacy of intracoronary tirofiban administration in patients with serious thrombus burden and ST-elevation myocardial infarction undergoing percutaneous coronary intervention[J].Eur Rev Med Pharmacol,2014;18(23):3690-5.