麝香保心丸联合法舒地尔治疗急性心肌梗死的临床疗效及其对微炎症状态、血管内皮功能的影响

摘要

目的：观察麝香保心丸联合法舒地尔治疗急性心肌梗死的临床疗效，并探讨其对微炎症状态、血管内皮功能的影响。方法选取2013年12月—2015年6月广州市第一人民医院心内科、急诊科收治的急性心肌梗死患者106例，根据随机数字表法分为联合组和法舒地尔组，各53例。在常规处理及常规药物治疗基础上，法舒地尔组患者给予盐酸法舒地尔治疗，联合组患者给予麝香保心丸联合盐酸法舒地尔治疗，两组疗程均为14 d。比较两组患者治疗前后微炎症状态〔包括血清白介素6（IL-6）、超敏 C 反应蛋白（hs-CRp）、肿瘤坏死因子α（TNF-α）水平〕、血管内皮功能〔包括血浆一氧化氮（NO）、内皮素（ET）水平〕、心功能〔包括左心室射血分数（LVEF）、左心室收缩末期容积（LVESV）〕及临床疗效、治疗期间药物不良反应发生情况。结果治疗前两组患者血清 IL-6、hs-CRp、TNF-α水平比较，差异无统计学意义（ P >0.05）；治疗后联合组患者血清 IL-6、hs-CRp、TNF-α水平低于法舒地尔组（ P <0.05）。治疗前两组患者血浆 NO、ET 水平比较，差异无统计学意义（P >0.05）；治疗后联合组患者血浆 NO 水平高于法舒地尔组、血浆 ET 水平低于法舒地尔组（P <0.05）。治疗前两组患者 LVEF、LVESV 比较，差异无统计学意义（P>0.05）；治疗后联合组患者 LVEF 高于法舒地尔组，LVESV 小于法舒地尔组（P <0.05）。联合组患者临床疗效优于法舒地尔组（P <0.05）。治疗期间两组患者均未出现明显药物不良反应。结论麝香保心丸联合法舒地尔治疗急性心肌梗死的临床疗效确切，能有效改善患者微炎症状态、血管内皮功能及心功能，且安全性较高。%Objective To observe the clinical effect of shexiangbaoxin pills combined with fasudil on acute myocardial infarction,to investigate the impact on micro - inflammatory state and vascular endothelial function. Methods From December 2013 to June 2015 in the Department of Cardiology and Emergency,the First people′s Hospital of Guangzhou,a total of 106 patients with acute myocardial infarction were selected,and they were divided into A group and B group according to random number table,each of 53 cases. Based on conventional treatment and conventional drugs,patients of A group received extra fasudil hydrochloride,while patients of B group received shexiangbaoxin pills combined with fasudil hydrochloride;both groups treated for 14 days as a course. Micro - inflammatory state related index(including serum levels of IL-6,hs-CRp and TNF-α), index of vascular endothelial function( including plasma levels of NO and ET),of cardiac function( including LVEF and LVESV),clinical effect and incidence of adverse drug reactions during treatment were compared between the two groups. Results No statistically significant differences of serum level of IL-6,hs-CRp or TNF-α was found between the two groups before treatment(P > 0. 05),while serum levels of IL-6,hs-CRp and TNF-α of B group were statistically significantly lower than those of A group after treatment(P < 0. 05). No statistically significant differences of plasma level of NO or ET was found between the two groups before treatment(P > 0. 05);after treatment,plasma NO level of B group was statistically significantly higher than that of A group,while plasma ET level of B group was statistically significantly lower than that of A group( P < 0. 05). No statistically significant differences of LVEF or LVESV was found between the two groups before treatment( P > 0. 05);after treatment,LVEF of B group was statistically significantly higher than that of A group,while LVESV of B group was statistically significantly smaller than that of A group(P < 0. 05). The clinical effect of B group was statistically significantly better than that of A group(P < 0. 05). No one of the two groups occurred any obvious adverse drug reactions during treatment. Conclusion Shexiangbaoxin pills combined with fasudil has certain clinical effect in treating acute myocardial infarction,can effectively improve the micro - inflammatory state,vascular endothelial function and cardiac function.