丹红注射液联合替罗非班对急性心肌梗死患者心功能、心肌酶谱及脂蛋白相关磷脂酶A2水平的影响
Effects of Danhong injection combined with tirofiban on cardiac function, myocardial enzyme spectrum and lipoprotein-associated phospholipase A2 level in patients with acute myocardial infarction.
作者信息
Qian Kai, Chen Qiaoying, Ding Hong, Fu Dan, Sun Saige, Hu Yunliang, Li Lei
机构信息
Department of Cardiology, Institute of Cardiovascular Development and Translational Medicine, The Second Affiliated Hospital of Wenzhou Medical University Wenzhou 325027, Zhejiang, China.
Medical College of Yichun University Yichun 336000, Jiangxi, China.
出版信息
Am J Transl Res. 2022 Nov 15;14(11):7951-7959. eCollection 2022.
OBJECTIVE
To determine the effect of Danhong injection combined with tirofiban on cardiac function, myocardial enzyme spectrum and lipoprotein-associated phospholipase A2 (Lp-PLA2) level in patients with acute myocardial infarction (AMI).
METHODS
The clinical data of 124 AMI patients who were treated in the Second Affiliated Hospital of Wenzhou Medical University from August 2019 to April 2021 were collected and analyzed retrospectively. Among them, 58 patients treated with routine thrombolysis combined with tirofiban were assigned to the control group, and the other 66 patients treated with Danhong injection on the basis of treatment to the control group were assigned to the observation group. Treatment efficacy, cardiac function, myocardial enzyme spectrum, and Lp-PLA2 level before and after treatment, and adverse cardiovascular events during treatment were compared between the two groups. The patients were further grouped into an occurrence group and a non-occurrence group in the light of the occurrence of adverse cardiovascular events after treatment, and then the risk factors of adverse cardiovascular events were analyzed by logistic regression.
RESULTS
The control group showed a notably lower total effective rate than the observation group (P=0.015). After treatment, the observation group showed a higher left ventricular ejection fraction (LVEF) level and a lower left ventricular end-diastolic dimension (LVEDD) than the control group (both P < 0.05). In addition, the observation group showed lower levels of CK, CK-MB and Lp-PLA2 than the control group (all P < 0.05). A significantly higher incidence of adverse cardiovascular events was found in the control group than that in the observation group (P=0.039), and Logistic regression analysis showed that NYHA grade, LVEF, LVEDD, CK-MB and Lp-PLA2 were independent risk factors (P < 0.05). The prediction model =-86.255 + (4.645NYHA grade) + (-0.581LVEF) + (1.058LVEDD) + (0.263CK-MB) + (0.121*Lp-PLA2). According to the ROC curve analysis, the area under the curve of the model in predicting adverse cardiovascular events among patients was 0.970.
CONCLUSION
Danhong injection combined with tirofiban can improve the cardiac function, myocardial enzyme spectrum and Lp-PLA2 level in AMI patients.
目的
探讨丹红注射液联合替罗非班对急性心肌梗死（AMI）患者心功能、心肌酶谱及脂蛋白相关磷脂酶A2（Lp-PLA2）水平的影响。
方法
回顾性收集2019年8月至2021年4月在温州医科大学附属第二医院治疗的124例AMI患者的临床资料。其中，58例采用常规溶栓联合替罗非班治疗的患者作为对照组，另外66例在对照组治疗基础上加用丹红注射液的患者作为观察组比较两组治疗效果、治疗前后的心功能、心肌酶谱、Lp-PLA2水平及治疗期间心血管不良事件。根据治疗后心血管不良事件的发生情况将患者进一步分为发生组和未发生组，然后采用logistic回归分析心血管不良事件的危险因素。
结果
对照组总有效率显著低于观察组（P=0.015）。治疗后，观察组左心室射血分数（LVEF）水平高于对照组，左心室舒张末期内径（LVEDD）低于对照组（均P<0.05）。此外，观察组CK、CK-MB和Lp-PLA2水平低于对照组（均P<0.05）。对照组心血管不良事件发生率显著高于观察组（P=0.039），logistic回归分析显示NYHA分级、LVEF、LVEDD、CK-MB和Lp-PLA2是独立危险因素（P<0.05）。预测模型=-86.255+(4.645×NYHA分级)+(-0.581×LVEF)+(1.058×LVEDD)+(0.263×CK-MB)+(0.121×Lp-PLA2)根据ROC曲线分析，该模型预测患者心血管不良事件的曲线下面积为0.970。
结论
丹红注射液联合替罗非班可改善AMI患者的心功能、心肌酶谱及Lp-PLA2水平。
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