摘要
目的观察重组人脑利钠肽联合美托洛尔对老年急性ST段抬高心肌梗死(STEMI)患者心功能及心肌损伤的影响。方法采用随机数字表法将2023年1—12月南京医科大学附属无锡人民医院收治的老年急性STEMI患者86例分为2组,其中,对照组43例给予基础治疗联合美托洛尔治疗,研究组43例在对照组基础上联合重组人脑利钠肽治疗,2组均治疗7 d。比较2组治疗前后心功能指标[左室射血分数(LVEF)、左室短缩率(LVFS)、左室收缩末期容积(LVESV)]、心肌损伤指标[肌酸激酶同工酶(CK-MB)、心肌肌钙蛋白I(cTnI)、N末端脑利尿钠肽前体(NT-proBNP)],主要不良心血管事件(MACE)及不良反应。结果与治疗前比较,治疗7 d后,2组LVEF、LVFS均升高,LVESV均缩小,CK-MB、cTnI、NT-proBNP水平均降低,且研究组变化幅度大于对照组(P<0.01)。研究组MACE总发生率低于对照组(4.65%vs.18.60%,χ^(2)=4.074,P=0.044)。研究组与对照组不良反应总发生率比较无统计学差异(9.30%vs.4.65%,χ^(2)=0.179,P=0.672)。结论重组人脑利钠肽联合美托洛尔可改善老年急性STEMI患者心功能及心肌损伤,有利于减少MACE,且安全性较高。
Objective To observe the effects of recombinant human brain natriuretic peptide combined with metoprolol on cardiac function and myocardial injury in older adults with acute STEMI.Methods Eighty-six cases of elderly STEMI patients admitted to Wuxi People′s Hospital Affiliated to Nanjing Medical University from January to December 2023 were selected,and they were divided into two groups according to the method of randomized numerical table.The 43 cases in control group was treated with basic therapy combined with metoprolol,and the 43 cases in research group was treated with recombinant human brain natriuretic peptide on the basis of the control group,and both groups were treated for 7 days.Cardiac function indexes(LVEF,LVFS,LVESV),myocardial injury indexes(CK-MB,cTnI,NT-proBNP)before and after treatment,MACE and adverse reactions were compared between the two groups.Results Compared with pre-treatment,after 7 days of treatment,the LVEF and LVFS of the two groups were improved,and the LVESV was narrowed,and the levels of CK-MB,cTnI and NT-proBNP were decreased,and the magnitude of change in the research group was greater than that in the control group(P<0.01).The total incidence of MACE in the research group was lower than that in the control group(4.65%vs.18.60%,χ^(2)=4.074,P=0.044).There was no statistically significant difference in the comparison of the total inc idence of adverse reactions between the research group and control group(9.30%vs.4.65%,χ^(2)=0.179,P=0.672).Co nclusion Recombinant human brain natriuretic peptide combined with metoprolol can improve cardiac function and myocardial injury in elderly STEMI patients,which is beneficial to reduce MACE and it has the good safety.
作者
裴俞妹
朱晓华
PEI Yumei;ZHU Xiaohua(Department of Pharmacy,Wuxi People′s Hospital Affiliated to Nanjing Medical University,Jiangsu Province,Wuxi 214023,China)
出处
《临床合理用药》
2025年第17期5-7,11,共4页
Chinese Journal of Clinical Rational Drug Use
关键词
ST段抬高心肌梗死
急性
老年
重组人脑利钠肽
美托洛尔
心功能
心肌损伤
ST segment elevation myocardial infarction,acute,older adults
Recombinant human brain natriuretic peptide
Metoprolol
Cardiac function
Myocardial injury
