参麦注射液联合溶栓治疗对急性心肌梗塞患者心室功能及血清CRP、BNP、IL-6水平的影响

摘要

目的:观察参麦注射液联合溶栓治疗对急性心肌梗塞患者心室功能及血清CRP、BNP、IL-6水平的影响.方法:选取符合纳入标准的急性心肌梗塞患者84例,随机分为研究组和对照组,每组42例,对照组采用常规溶栓治疗,研究组采用参麦注射液联合溶栓治疗,2周为1个疗程.1个疗程后观察比较两组患者临床疗效,CRP、BNP、IL-6水平及左心室舒张末内径和射血分数变化,并统计治疗期间不良反应发生情况从而评价参麦注射液在急性心肌梗塞治疗中的价值.且本研究同时测定BNP、CRP和IL-6三个指标,探究三个指标联合应用对AMI预后判断的价值.结果:治疗后两组患者的CRP、BNP、 IL-6水平均有所降低,且研究组降低幅度更为明显(P＜0.05).研究组治疗总有效率为95.24 ％,高于对照组的83.33 ％,但无显著性差异(P＞0.05).两组左心室射血分数治疗后均有一定程度升高,且研究组优于对照组(P＜0.05),但其左心室舒张末内径治疗前后无明显差异(P ＞0.05).治疗期间两组均出现不良反应,但无明显差异(P ＞0.05).结论:BNP、CRP和IL-6是AMI早期诊断的重要指标,具有重要的预判价值.参麦注射液联合溶栓治疗急性心肌梗塞相较于常规溶栓治疗,有利于改善BNP、CRP和IL-6水平,具有一定的临床意义.%Objective: To observe the effects of Shenmai injection combined with thrombolytic therapy for acute myocardial infarction(AMI)patients, and to discuss its impact on ventricular function, CRP, BNP and IL-6 in serum. Methods: 84 AMI patients were randomly divided into the observation group(n =42) and the control group (n =42 ). The control group was treated with conventional thrombolytic therapy; on which basis, the observation group was also given Shenmai injection. After a course of treatment, clinical efficacy was compared between the two groups. The levels of BNP, CRP and IL-6 were detected. Also, ejection fraction and diastolic diameter of left ventricle, and adverse reaction were observed to evaluate the effect of Danshen injection in the treatment of AMI. Results: The levels of BNP, CRP and IL-6 were all decreased after the treatment, and the changes of the observation group were more obvious, with statistically significant differences(P ＜0.05). The total effective rate was 95.24％ in the observation group, which was higher than 83.33％ in the control group, but the difference was not statistically significant(P ＞0.05). Ejection fraction of left ventricle were both increased in the two groups after the treatment, in which there was a significant difference(P ＜0.05); however, the difference of diastolic diameter was not statistically significant in the two groups(P ＞ 0.05 ). In terms of adverse reactions there was no obvious difference between the two groups (P ＞0.05). Conclusion: The combination of Shenmai injection with thrombolytic therapy was superior to thrombolytic therapy alone in improving the level of BNP, CRP and IL -6, reducing the incidence of adverse reaction, which is of great clinical significance.