摘要
目的探讨依洛尤单抗联合重组人脑利钠肽(rhBNP)治疗急性心肌梗死(AMI)患者的临床疗效,并分析其对心功能、氧化应激反应的影响。方法回顾性选取2020年10月至2023年1月于濮阳县人民医院诊治的106例AMI患者为研究对象,依据治疗方案不同分为单一组53例,联合组53例。两组予以经皮冠状动脉介入术(PCI)治疗,在此基础上单一组予以rhBNP治疗,联合组予以依洛尤单抗联合rhBNP治疗。统计对比两组临床疗效及治疗前后血流动力学、心功能[左室射血分数(LVEF)、心输出量(CO)、左室舒张末期容积(LVEDV)、左室收缩末期内径(LVESD)]、病情相关因子[N末端B型利钠肽原(NT-proBNP)、生长分化因子-15(GDF-15)、可溶性致癌抑制因子2(sST2)]、氧化应激[丙二醛(MDA)、过氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)]。比较两组不良反应及PCI术后6个月内心脏不良事件发生情况。结果联合组总有效率为92.45%,高于单一组的77.36%(P<0.05);联合组治疗3个月后平均左心房室瓣压力差、左心房平均压、肺动脉平均压低于单一组(P<0.05);与单一组比较,联合组治疗后LVEF、CO升高,LVEDV、LVESD降低(P<0.05);与单一组比较,联合组治疗后血清NT-proBNP、GDF-15、sST2水平降低(P<0.05);与单一组比较,联合组治疗后血清MDA水平降低,血清SOD、GSH-Px水平升高(P<0.05);两组不良反应比较差异无统计学意义(P>0.05);联合组PCI术后6个月内心脏不良事件发生率为7.55%,低于单一组的24.53%(P<0.05)。结论依洛尤单抗联合rhBNP治疗AMI的疗效确切,可改善血流动力学,促进心功能恢复,缓解病情进展,减轻氧化应激损伤,减少心脏不良事件发生,且具有一定安全性。
Objective To investigate the clinical efficacy of elotuzumab combined with recombinant human brain natriuretic peptide(rhBNP)on acute myocardial infarction(AMI),and to analyze its effects on cardiac function and oxidative stress response.Methods A total of 106 AMI patients diagnosed and treated in the Puyang People's Hospital from October 2020 to January 2023 were retrospectively included as the research objects.They were assigned into the single group and combination group,with 53 cases per group.Percutaneous coronary intervention(PCI)was performed in both groups,and patients in the single group were treated with the monotherapy of rhBNP,while those in the combination group were treated with elotuzumab combined with rhBNP.Clinical efficacy was measured.Hemodynamic data,cardiac function(left ventricular ejection fraction[LVEF],cardiac output[CO],left ventricular end-diastolic volume[LVEDV],left ventricular end-systolic diameter[LVESD]),disease-related factors(N-terminal pro-brain natriuretic peptide[NT-proBNP],growth differentiation factor-15[GDF-15],soluble tumor suppressor 2[sST2]),and oxidative stress(malondialdehyde[MDA],superoxide dismutase[SOD],glutathione peroxidase[GSH-Px])before and after treatment were compared between groups.Adverse events and the incidence of cardiac adverse events within six months of PCI were compared.Results The total effective rate was significantly higher in the combination group than that of single group(92.45%VS 77.36%,P<0.05).After 3 months of treatment,the average left atrial valve pressure difference,average left atrial pressure,and average pulmonary artery pressure in the combination group were significantly lower than those of the single group(P<0.05).Compared with those of the single group,patients in the combination group had significantly higher LVEF and CO,and lower LVEDV and LVESD after treatment(P<0.05).Compared with those of the single group,patients in the combination group showed significantly lower serum NT-proBNP,GDF-15,and sST2 levels after treatment(P<0.05).Compared with those of the single group,patients in the combination group had significantly lower serum MDA and higher serum SOD and GSH-Px levels after treatment(P<0.05).There was no significant difference in the incidence of adverse events between the two groups(P>0.05).The incidence of adverse cardiac events within 6 months of PCI was significantly lower in the combination group than that of single group(7.55%VS 24.53%,P<0.05).Conclusion Evolocumab combined with rhBNP has a definite therapeutic effect on AMI,which can improve hemodynamics and cardiac function recovery,and alleviate disease progression,oxidative stress,and the occurrence of adverse cardiac events,with a high safety.
作者
张艳敏
贺趋埔
韩会宁
季慧娟
ZHANG Yan-min;HE Qu-pu;HAN Hui-ning;JI Hui-juan
出处
《中国疗养医学》
2024年第7期87-92,共6页
Chinese Journal of Convalescent Medicine
基金
河南省医学科技攻关联合共建项目(LHGJ20211359)。
关键词
急性心肌梗死
依洛尤单抗
重组人脑利钠肽
心功能
氧化应激
Acute myocardial infarction
Evolocumab
Recombinant human brain natriuretic peptide
Heart function
Oxidative stress
作者简介
通信作者:张艳敏,fyhr58hfg@163.com。
