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投稿时间：2019-12-05 网络发布日期：2020-08-20
投稿时间：2019-12-05 网络发布日期：2020-08-20
中文摘要: 目的 探讨美托洛尔联合依折麦布对老年心肌梗死患者功能康复及正五聚体素3(PTX3)、亲环素A(CyPA)血清水平的干预作用。方法 选取2015年11月至2019年5月收治的心肌梗死老年患者129例进行回顾性研究,根据治疗方案分为对照A组、对照B组、联合组,各43例。常规干预基础上对照A组采用美托洛尔,对照B组采用依折麦布,联合组采用美托洛尔+依折麦布,三组均治疗4周。统计三组临床疗效、治疗前及治疗4周后心功能［左室射血分数(LVEF)、心脏指数(CI)、每搏输出量(SV)］、心室重构指标［左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、左室舒张末期内径(LVEDD)］、血清PTX3及CyPA水平、不良反应,随访1个月统计三组不良心血管事件发生率。结果 (1)临床疗效:联合组总有效率高于对照A组(93.02% vs 72.09%,P<0.017);(2)心功能:治疗4周后三组LVEF、CI、SV较治疗前增高,且联合组高于对照A组、对照B组(P<0.01);(3)心室重构:治疗4周后三组LVESV、LVEDV、LVEDD较治疗前减小,且联合组小于对照A组、对照B组(P<0.01);(4)PTX3及CyPA:治疗4周后三组血清PTX3及CyPA水平较治疗前降低,且联合组血清PTX3及CyPA水平低于对照A组、对照B组(P<0.01);(5)不良反应:联合组不良反应发生率(13.95%)与对照A组(9.30%)、对照B组(6.98%)比较无统计学差异(P>0.05);(6)不良心血管事件:联合组不良心血管事件发生率(4.65%)略低于对照A组(11.63%)、对照B组(11.63%),但组间差异无统计学意义(P>0.05)。结论 联合采取美托洛尔及依折麦布治疗心肌梗死老年患者,可有效改善其心功能及心室重构，提高疾病整体治疗效果,改善患者预后,其原因可能与该联合方案可有效降低PTX3及CyPA水平具有一定关联性,且安全可靠。
Abstract:ObjectiveTo investigate the intervention effect of metoprolol combined with ezetimibe on functional rehabilitation and serum levels of pentraxin 3(PTX3) and cyclophilin A (CyPA) in elderly patients with myocardial infarction.MethodsA total of 129 elderly patients with myocardial infarction from November 2015 to May 2019 were enrolled for restrospective study and divided into control group A,control group B and combination group according to the treatment regimen (n=43,each ).On the basis of routine intervention,metoprolol was given in control group A,ezetimibe was used in control group B,and metoprolol with ezetimibe was given in combination group.Medication was continued for 4 weeks in three groups.The clinical efficacy,cardiac function indexes,including left ventricular ejection fraction (LVEF),cardiac index (CI),stroke volume (SV),ventricular remodeling index,including left ventricular end-systolic volume (LVESV),left ventricular end-diastolic volume (LVEDV),left ventricular end-diastolic diameter (LVEDD),serum PTX3 and CyPA levels and adverse reactions were observed and analyzed in three groups.The incidence of adverse cardiovascular events was recorded at one-month followed-up.ResultsThe total effective rate in combination group(93.02%) was significantly higher than that in control group A(72.09%)(P<0.017).After 4 weeks of treatment,LVEF,CI and SV were statistically higher than those before treatment in three groups and were higher in combination group than those in control group A and B (P<0.01);LVESV,LVEDV and LVEDD decreased significantly compared with those before treatment in three groups and were lower in combination group than those in control group A and B (P<0.01);the serum levels of PTX3 and CyPA were lower than those before treatment in three groups and were significantly lower in combination group than those in control group A and B（P＜0.01）.There was no significant difference in the incidence of adverse reactions among three groups (P>0.05).The incidence of adverse cardiovascular events in combination group (4.65%) was slightly lower than that in control group A (11.63%) and control group B (11.63%),but there was no significant difference in them (P>0.05).ConclusionIn the treatment of elderly patients with myocardial infarction,the combination of metoprolol and ezetimibe can effectively improve the cardiac function and ventricular remodeling,improve the overall treatment effect and the prognosis of patients,which may be related to the decreasing serum PTX3 and CyPA levels by the combined regimen safely.
keywords: Metoprolol Ezetimibe Myocardial infarction Functional rehabilitation Cyclophilin A Pentraxin 3
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附件
| Author Name | Affiliation |
| SHANG Shuang-jian,SUN Mei-lan,ZHAO Xin | Cardiac Rehabilitation Center，Shijiazhuang First Hospital,Shijiazhuang,Hebei 050011,China |
引用文本：
尚双建,孙美兰,赵鑫.美托洛尔联合依折麦布对老年心肌梗死患者功能康复及血清CyPA、PTX3水平的干预作用[J].中国临床研究,2020,33(8):1041-1045.
尚双建,孙美兰,赵鑫.美托洛尔联合依折麦布对老年心肌梗死患者功能康复及血清CyPA、PTX3水平的干预作用[J].中国临床研究,2020,33(8):1041-1045.