冠心宁片早期治疗中老年急性ST段抬高型心肌梗死的疗效评估

Evaluation of efficacy of Guanxinning tablets in early treatment of middle-aged and older adults with acute ST-segment elevation myocardial infarction

中文关键词: 冠心宁片    中老年    急性ST段抬高型心肌梗死    6分钟步行试验    西雅图心绞痛量表    心肌总体顺应性

英文关键词: Guanxinning tabletsmiddle-aged and older adultsST-elevation myocardial infarction6-minute walk testSeattle angina questionnaiireglobal longitudinal strain

中文摘要:

      目的 观察冠心宁片联合抗凝和抗血小板药物在早期治疗中老年急性ST段抬高型心肌梗死(STEMI)患者中的疗效及其安全性。方法 收集2025年1月至12月中国人民解放军南部战区总医院64例已行介入治疗的中老年急性STEMI患者，采用计算机随机序列方法将患者分为观察组32例和对照组32例。对照组予依诺肝素钠抗凝和冠心病二级预防常规药物治疗，观察组在对照组治疗的基础上予冠心宁片治疗2周。1个月后通过西雅图心绞痛量表(SAQ)、6分钟步行试验(6MWT)、心肌总体顺应性(GLS)、实验室检查和中医证候积分等方式，对比2组患者心功能、缺血改善情况，以及出血风险的差异。结果 1个月后观察组患者SAQ的5个维度评分高于对照组(P <0.05)。观察组患者6MWT前后的血氧饱和度高于对照组，步行距离(462.19±62.80)m长于对照组(354.46±63.99)m，运动后心率波动小于对照组，差异均有统计学意义(均P <0.05)。观察组GLS(-16.91%±1.81%)高于对照组(-14.73%±2.63%)，观察组中医证候积分主要症状得分(2.69±2.81)分低于对照组(5.09±3.59)分，差异均有统计学意义(P <0.05)。短期出血风险、肝肾功能、不良反应和心血管事件发生率等方面，2组比较差异无统计学意义(P> 0.05)。结论 冠心宁片对缓解中老年STEMI患者早期心绞痛症状和改善心肺功能具有一定疗效，可提高患者疾病认知度，短期内不良反应发生率和出血风险较低。

英文摘要:

      Objective To observe the efficacy and safety of Guanxinning tablets combined with anticoagulant and antiplatelet drugs in the early treatment of middle-aged and older patients with acute ST elevation myocardial infarction(STEMI).Methods A total of 64 middle-aged and older STEMI patients who had undergone interventional therapy in General Hospital of Southern Theater Command of People's Liberation Army from January to December 2025 were collected.The patients were divided into observation group(n=32)and control group(n=32)using a computer-generated random sequence method.The control group received enoxaparin for anticoagulation and conventional secondary prevention medication for coronary heart disease,while the observation group was additionally treated with Guanxinning tablets for two weeks on the basis of the control group's regimen.After one month of treatment,differences in cardiac function,improvement of ischemia,and bleeding risk were compared between the two groups using the Seattle angina questionnaire(SAQ),6-minute walking test(6MWT),global longitudinal strain(GLS),laboratory tests,and traditional Chinese medicine(TCM)symptom scores.Results After one month,the SAQ scores across all five dimensions in the observation group were higher than those in the control group(P＜0.05).The blood oxygen saturation of the observation group before and after the 6MWT were higher than those of the control group,the walking distance(462.19±62.80)m was longer than that of the control group(354.46±63.99)m,and the heart rate fluctuations after exercise were smaller than those of the control group,and all the differences were statistically significant(all P＜0.05).The GLS score in the observation group(-16.91%±1.81%)was higher than that in the control group(-14.73%±2.63%),and the main symptom score of TCM syndrome in the observation group(2.69±2.81)was lower than that in the control group(5.09±3.59).Both differences were statistically significant(P＜0.05).There were no significant differences in short-term bleeding risk,liver and kidney function,adverse reactions,and cardiovascular risks between the two groups(P＞0.05).Conclusion Guanxinning tablets have a certain therapeutic effect on alleviating early angina symptoms and improving cardiopulmonary function in middle-aged and older STEMI patients,enhancing their disease awareness,with low incidence of adverse reactions and bleeding risk in the short term.