磷酸肌酸对老年ACS患者的疗效及安全性研究

摘要

Objective To evaluate the clinical efficacy and safety of creatine phosphate sodium in elderly patients with acute coronary syndrome (ACS).Methods A total of 79 cases of elderly patients with ACS (aged ≥65 years) were randomly divided into control group (n=35) and creatine phosphate group (CP group,n=44). Two groups were treated with routine medication, the CP group were added creatine (1g, 2/d) intravenous infusion therapy. Both groups were treated for 4 weeks. Before treatment, after 2 weeks of treatment (2 W) and four weeks of treatment (4 W), hypersensitive C reactive protein(hs-CRP), N terminal B type natriuretic titanium precursor(NT-proBNP), hypersensitive cardiac troponin T (hs-cTnT), cardiac troponin I (cTnI) and creatine phosphate metabolites: serum phosphorus (Sp) and serum creatinine (Scr) were measured.Results There was no significant difference between the two groups before treatment (P>0.05). At 2W and 4W, compared with the control group, the hs-cTnT of CP group was significantly decreased (P<0.05). At 2W, the hs-cTnT and cTnI of CP group decreased significantly (P>0.05). At 4W, the hs-CRP and NT-proBNP of CP group were significantly decreased (P>0.05). Compared with 2W, the hs-cTnT and cTnI of CP group were significantly decreased at 4W (P>0.05).Conclusion The levels of hs-CRP, NT-proBNP, hs-cTnT and cTNI in the elderly patients treated with sodium phosphate for 2 weeks and 4 weeks were significantly higher than those in the conventional treatment group, and the levels of serum phosphorus and serum creatinine were not significantly increased. The creatine phosphate sodium is effective in elderly patients with ACS and is worthy of clinical promotion.%目的 评价磷酸肌酸钠对老年急性冠脉综合征(ACS)患者的疗效和安全性.方法 连续入选2015年8月~2016年5月于中国人民解放军总医院南楼心内科住院并诊断为ACS的79例老年患者(年龄≥65岁),随机分为对照组(n=35)和磷酸肌酸组(n=44).两组同时接受常规药物治疗,磷酸肌酸组在常规药物治疗基础上增加磷酸肌酸(1 g,2/d)静脉滴注治疗,疗程4周.比较两组治疗前和治疗第2周(2 w)、第4周(4 w)时心肌损伤相关指标:高敏C反应蛋白(hs-CRP)、氨基末端脑钠肽前体(NT-proBNP)、高敏肌钙蛋白T(hs-cTnT)、肌钙蛋白I(cTnI)及磷酸肌酸相关代谢产物:血磷、血肌酐的变化.结果 治疗前两组指标无明显差异(P>0.05).与对照组2 w及4 w比较,磷酸肌酸组的hs-cTnT均出现了显著下降(P<0.05).组内比较,2 w时,磷酸肌酸组的hs-cTnT、cTnI即出现显著下降(P>0.05);到4 w时,磷酸肌酸组的hs-CRP、NT-proBNP出现显著下降(P>0.05);且4 w与2 w比较,磷酸肌酸组的hs-cTnT、cTnI再次出现显著下降(P>0.05).结论 老年ACS患者应用注射用磷酸肌酸钠治疗2 w、4 w后,hs-CRP、NT-proBNP、hs-cTnT、cTNI水平较常规治疗组下降更明显,血磷、血肌酐水平并未明显升高,对老年ACS患者疗效显著,值得在临床推广.