丹参多酚酸盐干预急性非ST段抬高型心肌梗死生物标志物研究

目的观察丹参多酚酸盐干预后急性非ST段抬高型心肌梗死(non-ST segment elevation myocardial infarction,NSTEMI)患者生物标志物的变化。方法将符合入选标准的2016年1月-2019年12月本院81例NSTEMI患者采用随机数字表法分为2组,治疗过程中,2组各脱落6例,最终对照组34;例、治疗组35例完成研究。对照组采用西医常规疗法治疗,治疗组在对照组基础上静脉滴注0.9%氯化钠注射液250 ml+注射用丹参多酚酸盐。2组均连续治疗10 d。采用胶乳免疫比浊法检测超敏C反应蛋白(high sensitivity CRP,hs-CRP),采用双抗夹心免疫化学发光法检测降钙素原(procalcitonin,PCT)、电化学发光法检测N末端B型利钠肽原(N-terminal pro-B-type natriuretic peptide,NT-proBNP)、凝固法检测血浆纤维蛋白原(fibrinogen,FIB)、免疫分析法检测D-二聚体。记录并采集患者住院期间(0~10 d)梗死后心绞痛发作次数,以及院内急性心力衰竭、院内再发心肌梗死、院内恶性心律失常、院内死亡等心血管不良事件。结果治疗后,治疗组hs-CRP(2.46±1.76)mg/L比(3.45±0.67)mg/L,t=2.324]、PCT(0.52±0.30)ng/L比(0.11±0.08)ng/L,t=2.059]、FIB(1.30±0.63)g/L比(1.97±0.67)g/L,t=2.168]水平均低于对照组(P<0.05),NT-proBNP和D-二聚体水平具有下降趋势,但组内及组间比较,差异无统计学意义(P>0.05)。住院期间,治疗组梗死后心绞痛发作次数低于对照组(t=4.019,P=0.045);院内急性心力衰竭发生率,以及院内再发心肌梗死、恶性心律失常和院内死亡的发生率组间比较,差异无统计学意义(P>0.05)。结论丹参多酚酸盐可在单纯西药治疗基础上降低NSTEMI患者的炎症反应,缓解高凝状态,减少梗死后心绞痛发作次数。

The clinical study of Salvianolate with intervention bioinformatics of patients with Non-ST-segment elevation myocardial infarction

Objective To observe the changes of biomarkers in patients with non-ST segment elevation myocardial infarction(NSTEMI)after intervention with Salvianolate.Methods A total 81 patients with NSTEMI who met the inclusion criteria from January 2016 to December 2019 were randomly divided into two groups.The control group dropped 6 cases,the treatment group dropped 6 cases,and finally each group had 35 cases.The control group was treated with conventional medicine therapy,and the treatment group was treated by intravenous drip of 0.9%NS 250 ml+Salvianolate on the basis of the control group.Both groups were treated continuously for 10 days.The latex immunoturbidimetric method was used to detect hypersensitive-C-Reactive-Protein(hs-CRP),double antibodysandwich immune chemiluminescence method for procalcitonin(PCT),electrochemiluminescence method for N-Terminal pro-B-type Natriuretic Peptide(NT-proBNP),coagulation method for plasma fibrinogen(FIB),and immunoassay for D-dimer.The number of episodes of angina pectoris after infarction,recurring myocardial infarction,malignant arrhythmia,and death in the hospital were recorded and collected during the hospitalization period(0-10 d).Results After treatment,hs-CRP(2.46±1.76 mg/L vs.3.45±0.67 mg/L,t=2.324),PCT(0.52±0.30 ng/L vs.0.11±0.08 ng/L,t=2.059),FIB(1.30±0.63 g/L vs.1.97±0.67 g/L,t=2.168)in the treatment group were significantly lower than those in the control group(P<0.05).After treatment,the level of NT-proBNP and D-dimer showed a downward trend,but there was no statistically significant difference within and between groups(P>0.05).During hospitalization,the number of angina pectoris after infarction in the treatment group was significantly lower than that of the control group(t=4.019,P=0.045),while the incidence of acute heart failure,recurring myocardial infarction,malignant arrhythmia and death in the hospital showed no significant difference(P>0.05).Conclusion Salvianolate can reduce the inflammatory response of NSTEMI patients on the basis of western medicine,relieve the hypercoagulable state,and reduce the number of angina pectoris after infarction.