CAJ | 학술논문

目的观察丹参多酚酸盐注射液对老年急性心肌梗死(AMI)患者血清妊娠相关蛋白-A(PAPP-A)、脑钠肽(BNP)和超敏C反应蛋白(hs CRP)浓度变化的影响. 方法检测160例老年AMI患者以及30例健康对照者的血清PAPP A、BNP和hs-CRP浓度;老年AMI患者被随机分为丹参多酚酸盐治疗组80例和常规治疗组80例,测定两组患者治疗前、治疗2周后血清PAPP-A、BNP、hs-CRP浓度. 结果 AMI患者治疗前PAPP-A、hs-CRP和BNP浓度分别为(12.88±2.56) mg/L、(20.13±5.35) mU/L和(412.0±69.5) ng/L,均高于健康对照组(1.20±0.88) mg/L、(1.90±0.46)mU/L和(89.0±5.6)ng/L(t=24.670、3.780、11.939,均P＜0.01).两组治疗前PAPP-A、hs-CRP和BNP浓度差异无统计学意义(t=0.864、0.712、0.985,均P＞0.05);治疗后PAPP-A、hsCRP、BNP浓度均较治疗前降低(均P＜0.05),且丹参多酚酸盐组治疗后PAPP-A、hs-CRP、BNP浓度分别为(3.83±1.20) mg/L、(1.33±0.38) mU/L和(105.0±31.2) ng/L,较常规治疗组(5.71±1.93)mg/L、(1.81±0.72)mU/L和(150.0±36.7) ng/L改善更明显(t=7.399、5.273、8.356,均P＜0.05) 结论 PAPP-A、hs-CRP和BNP浓度可作为观察AMI病情的临床指标;丹参多酚酸盐注射液能降低老年AMI患者血清PAPP-A、hs CRP和BNP的浓度,提示丹参多酚酸盐注射液具有抗炎及改善心功能的作用,但其作用机制仍需进一步探讨.
목적 관찰단삼다분산염주사액대노년급성심기경사(AMI)환자혈청임신상관단백-A(PAPP-A)、뇌납태(BNP)화초민C반응단백(hs CRP)농도변화적영향. 방법 검측160례노년AMI환자이급30례건강대조자적혈청PAPP A、BNP화hs-CRP농도;노년AMI환자피수궤분위단삼다분산염치료조80례화상규치료조80례,측정량조환자치료전、치료2주후혈청PAPP-A、BNP、hs-CRP농도. 결과 AMI환자치료전PAPP-A、hs-CRP화BNP농도분별위(12.88±2.56) mg/L、(20.13±5.35) mU/L화(412.0±69.5) ng/L,균고우건강대조조(1.20±0.88) mg/L、(1.90±0.46)mU/L화(89.0±5.6)ng/L(t=24.670、3.780、11.939,균P＜0.01).량조치료전PAPP-A、hs-CRP화BNP농도차이무통계학의의(t=0.864、0.712、0.985,균P＞0.05);치료후PAPP-A、hsCRP、BNP농도균교치료전강저(균P＜0.05),차단삼다분산염조치료후PAPP-A、hs-CRP、BNP농도분별위(3.83±1.20) mg/L、(1.33±0.38) mU/L화(105.0±31.2) ng/L,교상규치료조(5.71±1.93)mg/L、(1.81±0.72)mU/L화(150.0±36.7) ng/L개선경명현(t=7.399、5.273、8.356,균P＜0.05) 결론 PAPP-A、hs-CRP화BNP농도가작위관찰AMI병정적림상지표;단삼다분산염주사액능강저노년AMI환자혈청PAPP-A、hs CRP화BNP적농도,제시단삼다분산염주사액구유항염급개선심공능적작용,단기작용궤제잉수진일보탐토.
Objective To observe the effects of salvianolate injection on blood levels of high sensitively C-reactive protein (hs-CRP),pregnancy associated plasma protein-A (PAPP-A) and brain natriuretic peptide (BNP) in elderly patients with acute myocardial infarction.Methods The elderly patients with AMI (AMI group,n=160) and healthy controls (control group.n=30) were enrolled in this study and their blood concentrations of PAPP A,hs CRP and BNP were detected before and two weeks after treatment.The elderly patients in AMI group were randomized into conventional treatment group (n =80) and salvianolate group (n =80).Results The levels of PAPP-A,hs-CRP and BNP were significantly higher in AMI patients [(12.88±2.56) mg/L,(20.13 ±5.35) mU/L,(412.0±69.5) ng/L,respectively] than in healthy subjects[(1.20±0.88) mg/L,(1.90±0.46) mU/L,(89.0±5.6) ng/L,respectively] (t=24.670,3.780,11.939,respectively,P ＜0.01).But,before treatment there were no significant differences in the levels of PAPP-A,hs-CRP and BNP between the AMI group and control group (t=0.864,0.712,0.985,all P＞0.05).After two weeks of treatment,as compared with control group,AMI group showed that the serum concentrations of PAPP-A,hs-CRP and BNP were decreased significantly (P＜0.05).The levels of PAPP A,hs-CRP and BNP were (3.83±1.20) mg/L,(1.33±0.38) mU/L,(105.0±31.2) ng/L in salvianolate group and (5.71± 1.93) mg/L,(1.81±0.72) mU/L,(150.0±36.7) ng/L in conventional treatment group respectively,and the decrements in levels of PAPP-A,hs CRP and BNP were greater in the former than in the latter(t=7.399,5.273,8.356,respectively,all P＜0.05).Conclusions The dynamic serum concentrations of PAPP-A,hs CRP and BNP can be used as clinical indexes for the prognosis of acute myocardial infarction.Salvianolate injection can significantly decrease the serum levels of PAPP A,hs CRP and BNP.The salvianolate injection may have anti inflammatory effect and improve cardiac function in elderly patients with acute myocardial infarction,but the mechanism is still to be further discussed.