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目的:探讨参麦注射液联合双抗治疗对老年非ST段抬高型急性冠脉综合征患者血清MMP-9、TNF-α及IL-6水平的影响。方法:研究对象为80例老年非ST段抬高型急性冠脉综合征患者,均接受常规治疗,对照组给予阿司匹林及氯吡格雷双抗治疗,研究组在此基础上再予参麦注射液静点,连续治疗4 d。检测治疗前、后血清炎性因子及心肌损伤标志物,胸痛发作情况及出血情况,血小板聚集率及主要心血管发生率,比较临床疗效。结果:与治疗前比较,两组血清血清肿瘤坏死因子α(tumor necrosis factor,TNF-α)、白介素-6(interleukin-6,IL-6)及C反应蛋白(C-reactionprotein,CRP)水平均显著降低(P<0.01),肌钙蛋白T(cardiac troponin T,cTnT)、肌酸激酶同工酶(isoenzyme of creatine kinase,CK-MB)水平均明显升高(P<0.05),基质金属蛋白酶-9(matrix metallo preteinases-9,MMP-9)水平明显降低(P<0.05),胸痛发作频率显著降低(P<0.01),持续时间显著缩短(P<0.01);与对照组比较,研究组血清TNF-α、IL-6及CRP水平较低(P<0.01),cTnT、CKMB水平较低,MMP-9水平较低(P<0.05),胸痛发作频率较低(P<0.01),持续时间较短(P<0.01),血小板聚集率较低(P<0.01),主要心血管发生率较低(P<0.01),治疗有效率较高(P<0.01)。结论:参麦注射液联合双抗治疗老年非ST段抬高型急性冠脉综合征有显著疗效,能明显改善胸痛,且能降低血清MMP-9、TNF-α及IL-6水平。
Objective: To investigate the effects of Shenmai injection combined with double-antibody on serum MMP-9, TNF-α and IL-6 in elderly patients with non-ST segment elevation acute coronary syndrome. Methods: The subjects of the study were 80 elderly patients with non-ST-segment elevation acute coronary syndrome who underwent conventional therapy. The control group was given aspirin and clopidogrel dual therapy. On the basis of this, the study group was given Shenmai injection Static point, continuous treatment 4 d. Pre and post-treatment serum inflammatory cytokines and markers of myocardial injury, chest pain and bleeding, platelet aggregation and the incidence of major cardiovascular events, clinical efficacy. Results: Compared with before treatment, serum levels of tumor necrosis factor (TNF), interleukin-6 (IL-6) and C-reaction protein (CRP) (P <0.01). The levels of cardiac troponin T (cTnT) and isoenzyme of creatine kinase (CK-MB) were significantly increased (P <0.05) (P <0.01), and the duration of chest pain was significantly decreased (P <0.01). Compared with the control group, the levels of MMP-9 and matrix metalloproteinase-9 Serum levels of TNF-α, IL-6 and CRP were lower (P <0.01), cTnT and CKMB levels were lower, MMP-9 level was lower (P <0.05), chest pain frequency was lower (P <0.01) (P <0.01), platelet aggregation rate was lower (P <0.01), the main cardiovascular incidence was lower (P <0.01), and the treatment efficiency was higher (P <0.01). Conclusion: Shenmai injection combined with double antibody has significant curative effect on senile non-ST segment elevation acute coronary syndrome, can obviously improve chest pain, and can reduce the level of serum MMP-9, TNF-α and IL-6.