艾司洛尔联合曲美他嗪治疗急性心肌梗死的疗效及对血清NT-proBNP、sST2、PTX3水平的影响

摘要

目的 探讨艾司洛尔联合曲美他嗪治疗急性心肌梗死的疗效及对血清N末端钠尿肽前体(NT-proBNP)、可溶性致癌抑制因子2(sST2)、五聚素3(PTX3)水平的影响.方法 选择2016年5月至2018年5月于海南省中医院急诊科收治的急性心肌梗死患者90例,随机分为观察组(n=47)和对照组(n=43).对照组应用曲美他嗪治疗,观察组在对照组基础上联合艾司洛尔治疗.比较两组患者的临床疗效、血清NT-proBNP、sST2、PTX3、左室舒张末期内径(LVEDd)、左室射血分数(LVEF)、左室收缩末期内径(LVESd)及不良反应发生情况.结果 治疗后,观察组治疗总有效率高于对照组(95.74% vs. 69.77%,P＜0.05);两组患者治疗前NT-proBNP、sST2、PTX3无明显差异;治疗后两组NT-proBNP、sST2、PTX3均明显下降,且观察组NT-proBNP、sST2、PTX3显著低于对照组(P＜0.05);两组患者治疗前心功能无明显差异;治疗后,两组心功能均明显改善,且观察组LVEDd、LVESd显著低于对照组,LVEF显著高于对照组(P＜0.05);观察组不良反应发生率为6.38%,明显低于对照组的20.93%(P＜0.05).结论 在急性心肌梗死患者中应用艾司洛尔联合曲美他嗪效果显著,可有效改善血清NT-proBNP、sST2、PTX3水平.%Objective To discuss the curative effect of esmolol combined with trimetazidine on acute myocardial infarction (AMI) and its influence on levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), soluble suppression of tumorigenicity 2 (sST2) and pentraxin 3 (PTX3). Methods AMI patients (n=90) were chosen from Emergency Department in Hainan Provincial Hospital of Traditional Chinese Medicine from May 2016 to May 2018, and then they were randomly divided into observation group (n=47) and control group (n=43). The control group was treated with trimetazidine and observation group was treated with esmolol combined with trimetazidine. The clinical efficacy, levels of serum NT-proBNP, sST2 and PTX3, left ventricular end-diastolic inner diameter (LVEDd), left ventricular ejection fraction (LVEF), left ventricular end-systolic diameter (LVESd) and adverse reactions were compared between 2 groups. Results After treatment, the total effective rate was higher in observation group than that in control group (95.74% vs. 69.77%, P<0.05). The levels of NT-proBNP, sST2 and PTX3 had no significant differences between 2 groups before treatment and decreased significantly in 2 groups after treatment, and they were significantly lower in observation group than those in control group (P<0.05). The heart function had no significant differences between 2 groups before treatment and was significantly improved in 2 groups after treatment, and LVEDd and LVESd were significantly lower and LVEF significantly higher in observation group than those in control group (P<0.05). The incidence of adverse reactions was 6.38% in observation group and 20.93% in control group (P<0.05). Conclusion The application of esmolol combined with trimetazidine has significant curative effect in AMI patients, which can effectively improve the levels of NT-proBNP, sST2 and PTX3.