摘要
目的 基于血管内皮指标、白细胞介素-23(IL-23)、白细胞介素-17(IL-17)分析速效救心丸联合新活素对经皮冠状动脉介入术(PCI)后急性心肌梗死(AMI)患者的治疗效果。方法 选取2021年1月至2022年10月该院收治的104例AMI患者作为研究对象,根据随机数字表法分为对照组和观察组,各52例。两组均进行PCI,对照组术后采用新活素治疗,观察组术后采用新活素+速效救心丸治疗。比较两组疗效、不良反应、主要不良心血管事件(MACE)发生情况及治疗期间中医证候积分、心功能指标、血管内皮指标、血清IL-23、IL-17水平。结果 观察组总有效率高于对照组(P<0.05)。重复测量方差分析显示,两组治疗期间的中医证候积分、左心室射血分数(LVEF)、心脏指数(CI)、N末端脑钠肽前体(NT-proBNP)及血清IL-23、IL-17、血管内皮生长因子B(VEGF-B)、血管性假血友病因子(vWF)、生长分化因子-15(GDF-15)水平变化有交互效应(F=13.455、10.336、7.513、17.011、23.468、25.178、14.556、13.182、18.712,P<0.001),故进一步做单独效应分析。两组不同时间血清IL-23、IL-17、GDF-15、vWF水平及中医证候积分、NT-proBNP水平比较结果显示,治疗6个月后<治疗3个月后<治疗前,任意两两比较,差异均有统计学意义(P<0.05)。两组不同时间血清VEGF-B水平、LVEF、CI比较结果显示,治疗6个月后>治疗3个月后>治疗前,任意两两比较,差异均有统计学意义(P<0.05)。多变量方差分析结果显示,观察组治疗3个月后、6个月后血清IL-23、IL-17、vWF、GDF-15、NT-proBNP水平及中医证候积分低于对照组,血清VEGF-B水平及LVEF、CI均高于对照组,差异均有统计学意义(P<0.05)。两组治疗期间不良反应、MACE发生情况比较,差异无统计学意义(P>0.05)。结论 新活素联合速效救心丸应用于PCI后AMI患者的治疗,有助于下调患者血清IL-23、IL-17水平,改善治疗效果。
Objective To analyze the therapeutic effects of the combination of Suxiao Jiuxin Pill and Xinhuosu on Acute Myocardial Infarction(AMI)patients after percutaneous coronary intervention(PCI)on based on vascular endothelial markers,interleukin-23(IL-23)and interleukin-17(IL-17).Methods A total of 104 patients with AMI admitted to this hospital from January 2021 to October 2022 were selected as the research subjects and were divided into control group and observation group according to random number table method,with 52 cases in each group.Both groups underwent PCI.The control group was treated with Xinhuosu,and the observation group was treated with Xinhuosu+Suxiao Jiuxin Pill.The efficacy,adverse reactions,occurrence of major adverse cardiovascular events(MACE),as well as Traditional Chinese Medicine(TCM)syndrome scores,cardiac function indicators,vascular endothelial indicators and serum levels of IL-23 and IL-17 were compared between the two groups during the treatment period.Results The total effective rate in the observation group was higher than that in the control group(P<0.05).Repeated measures analysis of variance showed that there were interaction effects in TCM syndrome score,left ventricular ejection fraction(LVEF),cardiac index(CI),N-terminal pro-brain natriuretic peptide(NT-proBNP)and serum levels of IL-23,IL-17,vascular endothelial growth factor B(VEGF-B),von Willebrand factor(vWF),growth differentiation factor-15(GDF-15)of the two groups during treatment(F=13.455,10.336,7.513,17.011,23.468,25.178,14.556,13.182,18.712;P<0.001),so further separate effect analysis was performed.Comparisons of serum levels of IL-23,IL-17,GDF-15,vWF,as well as TCM syndrome scores and NT-proBNP levels between the two groups at different time points showed that after 6 months of treatment<after 3 months of treatment<before treatment,and the difference was statistically significant in any pairwise comparison(P<0.05).Comparisons of serum VEGF-B levels,LVEF,CI between the two groups at different time points showed that after 6 months of treatment>after 3 months of treatment>before treatment,and the difference was statistically significant in any pairwise comparison(P<0.05).The results of multivariate analysis of variance showed that the levels of serum IL-23,IL-17,vWF,GDF-15,NT-proBNP levels and TCM syndrome scores in the observation group were lower than those in the control group after 3 months and 6 months of treatment,and the level of serum VEGF-B,LVEF and CI were higher than those in the control group,with statistical significance(P<0.05).There were no statistically significant differences in adverse reactions and MACE occurrence between the two groups during treatment(P>0.05).Conclusion The combined application of Xinhuosu and Suxiao Jiuxin Pill in the treatment of AMI patients after PCI helps to downregulate the levels of serum IL-23 and IL-17,thereby improving the therapeutic effect.
作者
汤勇
帅文欢
邓翠东
TANG Yong;SHUAI Wenhuan;DENG Cuidong(Department of Cardiology,the Fourth People′s Hospital of Zigong,Zigong,Sichuan 643000,China)
出处
《检验医学与临床》
2025年第1期100-106,共7页
Laboratory Medicine and Clinic
基金
2021年四川省科研课题计划项目(S21192)。
