尼可地尔联合rhBNP对高血栓负荷前壁心肌梗死患者细胞凋亡因子及心肌微循环的影响OA
Influence of Nicorandil Combined with Recombinant Human Brain Natriuretic Peptide for Apoptosis Factors and Myocardial Microcirculation of Patients with Anterior Myocardial Infarction of High Thrombus Burden
目的:探究尼可地尔联合重组人脑利钠肽(rhBNP)对高血栓负荷前壁心肌梗死(简称心梗)患者细胞凋亡因子及心肌微循环的影响.方法:将 2022 年 3 月—2023 年 12 月昆山市第一人民医院的 100 例高血栓负荷前壁心梗患者根据随机数字表法分为两组.对照组的 50 例患者采用尼可地尔进行治疗,观察组的 50 例患者则采用尼可地尔联合rhBNP进行治疗.比较两组治疗后不同时间的不良心血管事件发生率、治疗前后的TIMI血流分级、细胞凋亡因子[可溶性凋亡相关因子(sFas)、可溶性凋亡相关因子配体(sFasL)、半胱氨酸蛋白酶-3(Caspase-3)及半胱氨酸蛋白酶-12(Caspase-12)]及心肌微循环指标(心肌声学造影参数A、β及A·β).结果:观察组治疗后 7 d及 30 d的不良心血管事件发生率均显著低于对照组,差异均有统计学意义(P<0.05).治疗前两组的TIMI血流分级、细胞凋亡因子及心肌微循环指标比较,差异均无统计学意义(P>0.05);治疗后观察组的TIMI血流分级显著优于对照组,细胞凋亡因子均显著低于对照组,心肌微循环指标均显著高于对照组,且两组治疗后的细胞凋亡因子均显著低于治疗前,心肌微循环指标均显著高于治疗前,差异均有统计学意义(P<0.05).结论:尼可地尔联合rhBNP在高血栓负荷前壁心梗患者中的应用效果较好,且可有效控制细胞凋亡因子的表达及改善心肌微循环的状态.
Objective:To investigate the influence of Nicorandil combined with Recombinant Human Brain Natriuretic Peptide(rhBNP)for apoptosis factors and myocardial microcirculation of patients with anterior myocardial infarction of high thrombus burden.Method:A total of 100 patients with anterior myocardial infarction of high thrombus burden in the First People's Hospital of Kunshan from March 2022 to December 2023 were divided into two groups by the method of random number table.50 cases of control group were treated with Nicorandil,50 cases of observation group were treated with Nicorandil combined with rhBNP.The adverse cardiovascular events rates at different time after the treatment,TIMI blood flow classification,apoptosis factors[soluble factor-related apoptosis(sFas),soluble factor-related apoptosis ligand(sFasL),Caspase-3 and Caspase-12]and myocardial microcirculation indexes(myocardial contrast echocardiography parameters A,β and A·β)before and after the treatment of two groups were compared.Result:The incidence of adverse cardiovascular events in the observation group at 7 and 30 days after treatment were significantly lower than those in the control group,the differences were statistically significant(P<0.05).The TIMI blood flow classification,apoptosis factors and myocardial microcirculation indexes of two groups before the treatment were compared,the differences were not statistically significant(P>0.05);the TIMI blood flow classification of observation group after the treatment was significantly better than that of control group,the apoptosis factors were significantly lower than those of control group,the myocardial microcirculation indexes were significantly higher than those of control group,the apoptosis factors of two groups after the treatment were significantly lower than those before the treatment,the myocardial microcirculation indexes were significantly higher than those before the treatment,the differences were statistically significant(P<0.05).Conclusion:The application effect of Nicorandil combined with rhBNP in patients with anterior myocardial infarction of high thrombus burden is better,and it can effectively control the expression of apoptosis factors and improve the myocardial microcirculation state of patients.
雷剑;张晋;许浩军
昆山市第一人民医院心血管内科 江苏 昆山 215300昆山市第一人民医院急诊医学科 江苏 昆山 215300
尼可地尔重组人脑利钠肽高血栓负荷前壁心梗细胞凋亡因子心肌微循环
NicorandilrhBNPAnterior myocardial infarction of high thrombus burdeApoptosis factorsMyocardial microcirculation
《中国医学创新》 2024 (020)
23-27 / 5
昆山市级科技专项(社会发展)指导性项目(KSZ2302)
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