复方丹参滴丸对急性心肌梗死患者经皮冠状动脉介入治疗术后血清微小RNA-1表达的影响

摘要

目的 观察复方丹参滴丸对急性心肌梗死(AMI)患者经皮冠状动脉(冠脉)介入治疗(PCI)术后血清微小RNA-1(miR-1)表达及炎症因子水平的影响.方法 选择宁德市闽东医院2017年3月至2018年10月收治的180例AMI患者,将患者按治疗方法不同分为复方丹参滴丸组和西医常规治疗组,每组90例.入组患者均根据病情需要进行PCI,术后西医常规治疗组给予阿司匹林肠溶片基础抗凝;复方丹参滴丸组在基础抗凝治疗的同时给予复方丹参滴丸,每次10粒、每日3次.两组均连续治疗2个月后评价疗效.采用超声心动图检测患者心功能;并观察两组患者治疗前后血清miR-1的表达水平和白细胞介素(IL-1、IL-6)、肿瘤坏死因子-α(TNF-α)以及心肌肌钙蛋白I(cTnI)、肌酸激酶同工酶(CK-MB)水平的变化.结果 两组治疗后左室射血分数(LVEF)、心排血指数(CI)均较治疗前升高,血清miR-1表达和IL-1、IL-6、TNF-α、cTNI和CK-MB均较治疗前降低.复方丹参滴丸组治疗后LVEF、CI均明显高于西医常规治疗组〔LVEF :0.60±0.08比0.56±0.08,CI(L·min-1·m-2):6.02±0.34比4.91±1.50,均P＜0.05〕,血清miR-1表达水平和IL-1、IL-6、TNF-α、cTnI、CK-MB均明显低于西医常规治疗组〔miR-1(2-ΔΔCt):0.69±0.17比0.85±0.22,IL-1(μg/L):59.20±18.67 比 68.31±23.69,IL-6(μg/L):20.36±1.87 比 25.38±2.39,TNF-α(μg/L):28.65±1.63 比31.86±2.92,cTnI(μg/L):3.12±0.88比4.03±0.97,CK-MB(U/L):29.18±10.52比34.28±10.21,均P＜0.05〕.结论 复方丹参滴丸可降低AMI患者PCI术后血清miR-1表达和炎症因子水平.%Objective To explore the effects of compound Danshen dripping pills on the expression levels of micro RNA-1 (miR-1) and inflammatory factors in serum of patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods A total of 180 AMI patients admitted to Mindong Hospital of Ningde City from March 2017 to October 2018 were divided into a compound Danshen dripping pills group and a conventional western medicine treatment group, 90 cases in each group. According to the disease situations of all the patients, they needed to undergo PCI treatment, after the intervention, in the conventional western medicine treatment group, aspirin enteric-coated tablet (metformin hydrochlorid) was given as the basic anti-coagulation medicine and in the compound Danshen dripping pill group, on the basic treatment, 10 Danshenn pills each time, 3 times a day, were orally applied. Both groups were evaluated for efficacy after 2 months of continuous treatment. Echocardiography was used to detect the patients' cardiac functions; the changes of the expression levels of serum miR-1, interleukins (IL-1, IL-6), tumor necrosis factor-α (TNF-α), and myocardial troponin I (cTnI) and creatine kinase isoenzyme (CK-MB) in the two groups before and after treatment were observed. Results After treatment in both groups, the left ventricular ejection fraction (LVEF) and cardiac output index (CI) were significantly higher than those before treatment, while the expression of miR-1 and serum IL-1, IL-6, TNF-α, cTnI and CK-MB were lower than those before treatment, the LVEF and CI in the compound Danshen dripping pill treatment group were obviously higher than those in the conventional western medicine treatment group [LVEF: 0.60±0.08 vs. 0.56±0.08, CI (L·min-1·m-2): 6.02±0.34 vs. 4.91±1.50, both P < 0.05], the expression level of miR-1 and serum IL-1, IL-6, TNF-α, cTnI and CK-MB in the compound Danshen dripping pill group were lower than those in the conventional western medicine treatment group [miR-1 (2-ΔΔCt): 0.69±0.17 vs. 0.85±0.22, IL-1 (μg/L): 59.20±18.67 vs. 68.31±23.69, IL-6 (μg/L): 20.36±1.87 vs. 25.38±2.39, TNF-α (μg/L): 28.65±1.63 vs. 31.86±2.92, cTnI (μg/L):3.12±0.88 vs. 4.03±0.97, CK-MB (U/L): 29.18±10.52 vs. 34.28±10.21, all P < 0.05]. Conclusion Compound Danshen dripping pills can reduce serum the expression levels of miR-1 and inflammatory cytokines in patients with AMI after PCI.