摘要
目的 研究地奥心血康胶囊联合阿司匹林治疗急性心肌梗死的效果.方法 回顾性选取2022年2月至2023年11月安康市中心医院收治的112例急性心肌梗死患者作为研究对象,根据治疗方法的不同将其分为对照组(n=58)和观察组(n=54).对照组采用阿司匹林治疗,观察组采用地奥心血康胶囊联合阿司匹林治疗.比较两组患者的疗效,比较两组患者治疗前、治疗30 d后的心肌梗死面积、血管内皮功能指标[血管紧张素(Ang)-Ⅱ及内皮素(ET)-1、血流介导的舒张功能(FMD)]、炎症因子[白细胞介素(IL)-1β、可溶性细胞间黏附因子-1(sICAM-1)、脂蛋白相关磷脂酶A2(Lp-PLA2)、IL-18]水平,并记录两组患者治疗期间的不良反应发生情况.结果 观察组总有效率为96.30％,显著高于对照组(84.48％),差异有统计学意义(P＜0.05).治疗30 d后,两组的心肌梗死面积均较治疗前减小,且观察组的心肌梗死面积为(24.39±1.17)％,小于对照组[(26.84±1.32)％],差异均有统计学意义(P＜0.05).治疗30 d后,两组的Ang-Ⅱ和ET-1水平较治疗前降低,FMD水平较治疗前升高,且观察组的Ang-Ⅱ和ET-1水平分别为(0.32±0.07)μg/mL、(63.59±11.84)μg/mL,均低于对照组[(0.43±0.09)μg/mL、(74.28±13.27)μg/mL],FMD水平为(6.23±0.95)％,高于对照组[(5.17±0.64)％],差异均有统计学意义(P＜0.05).治疗30 d后,两组的血清IL-1β、ICAM-1、Lp-PLA2和IL-18水平均较治疗前降低,且观察组的血清IL-1 β、ICAM-1、Lp-PLA2和IL-18 水平分别为(22.39±1.45)μg/mL、(127.94±11.36)μg/mL、(154.28±11.37)μg/L、(31.28±4.22)μg/mL,低于对照组[(28.41±2.53)μg/mL、(146.19±12.42)μg/mL、(169.35±15.24)μg/L、(42.15±7.62)μg/mL],差异均有统计学意义(P＜0.05).两组的皮疹、胃肠道反应、消化道出血和头晕发生率比较,差异均无统计学意义(P＞0.05).结论 地奥心血康胶囊联合阿司匹林能明显缩小心肌梗死面积,改善血管内皮功能,减轻炎症反应,疗效显著.
Abstract
Objective To investigate the effect of Di'ao Xinxuekang capsule combined with aspirin in the treatment of acute myocardial in-farction.Methods A retrospective study was conducted on 112 patients with acute myocardial infarction admitted to Ankang Central Hospital from February 2022 to November 2023.They were divided into control group(n=58)and observation group(n=54)according to different treat-ment methods.The control group was treated with aspirin,while the observation group was treated with Di'ao Xinxuekang capsules combined with aspirin.The efficacy of the two groups was compared.The myocardial infarction area,vascular endothelial function indexes[angiotensin(Ang)-Ⅱ and endothelin(ET)-1,flow-mediated diastolic(FMD)],inflammatory factors[interleukin(IL)-1 β,soluble intercellular adhesion molecule-1(sICAM-1),lipoprotein-associated phospholipase A2(Lp-PLA2),IL-18]were compared between the two groups before treatment and 30 days after treatment.The incidence of adverse reactions during treatment was recorded in the two groups.Results The total ef-fective rate of the observation group was 96.30％,which was significantly higher than that of the control group(84.48％),the difference was sta-tistically significant(P＜0.05).After 30 days of treatment,the myocardial infarction area of the two groups was smaller than that before treat-ment,and the myocardial infarction area of the observation group was(24.39±1.17)％,which was smaller than that of the control group[(26.84±1.32)％],the differences were statistically significant(P＜0.05).After 30 days of treatment,the levels of Ang-Ⅱ and ET-1 in the two groups were lower than those before treatment,and the levels of FMD were higher than those before treatment,the levels of Ang-Ⅱ and ET-1 in the observation group were(0.32±0.07)μg/mL and(63.59±11.84)μg/mL,respectively,which were lower than those in the control group[(0.43±0.09)μg/mL and(74.28±13.27)μg/mL],the level of FMD in the observation group was(6.23±0.95)％,which was higher than that in the control group[(5.17±0.64)％],and the differences were statistically significant(P＜0.05).After 30 days of treatment,the lev-els of serum IL-1 β,ICAM-1,Lp-PLA2 and IL-18 in the two groups were lower than those before treatment,and the levels of serum IL-1β,ICAM-1,Lp-PLA2 and IL-18 in the observation group were(22.39±1.45)μg/mL,(127.94±11.36)μg/mL,(154.28±11.37)μg/L and(31.28±4.22)μg/mL,respectively,which were lower than those in the control group[(28.41±2.53)μg/mL,(146.19±12.42)μg/mL,(169.35±15.24)µg/L,(42.15±7.62)μg/mL],and the differences were statistically significant(P＜0.05).There were no sta-tistically significant differences in the incidence of rash,gastrointestinal reactions,gastrointestinal bleeding,and dizziness between the two groups(P＞0.05).Conclusion The combination of Di'ao Xinxuekang Capsules and aspirin can significantly reduce the size of myocardial infarction,improve vascular endothelial function,alleviate inflammatory reactions,and have significant therapeutic effects.
维普
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