RESUMO
Objective:To investigate the effects of Xueshuan Xinmaining tablet combined with metoprolol on creatine kinase-MB and troponin in patients with coronary heart disease after percutaneous coronary intervention. Methods:A total of 104 patients with coronary heart disease who received percutaneous coronary intervention in Zhoushan Hospital from March 2020 to March 2021 were included in this study. They were randomly divided into observation and control groups ( n = 52/group). The control group was give metoprolol (oral, 25 mg once,3 times/day). The observation group was given Xueshuan Xinmaining tablet (2 tablets once, 3 times per day) based on medication given in the control group. Two groups were treated for 1 month. Clinical efficacy, changes in vascular endothelial function and serum inflammatory factors post-treatment relative to those before treatment, and the incidence of adverse reactions were compared between the two groups. Results:Total response rate in the observation group was significantly higher than that in the control group [86.54% (45/52) vs. 67.31% (35/52), χ2 = 4.99, P < 0.05]. After treatment, nitric oxide in the observation group was significantly higher than that in the control group [(67.23 ± 9.52) μmol/L vs. (60.49 ± 9.71) μmol/L, t = 3.57, P < 0.001]. Endothelin in the observation group was significantly lower than that in the control group [(53.12 ± 7.28) ng/L vs. (61.25 ± 8.36) ng/L, t = 5.28, P < 0.001]. Tumor necrosis factor α, C-reactive protein and interleukin-6 in the observation group were (39.51 ± 6.37) μg/L, (4.13 ± 1.02) mg/L, and (19.43 ± 2.57) μg/L, respectively, which were significantly lower than (51.37 ± 7.28) μg/L, (5.62 ± 1.15) mg/L, (26.16 ± 3.19) μg/L in the control group ( t = 8.84, 6.99, 11.84, all P < 0.05). Creatine kinase-MB and troponin in the observation group were (30.18 ± 5.89) U/L and (7.32 ± 1.12) ng/L, respectively, which were significantly lower than (41.74 ± 6.76) U/L and (9.63 ± 1.45) ng/L in the control group, respectively ( t = 9.29, 9.09, both P < 0.05). No serious adverse reactions occurred during the treatment period in each group. Conclusion:Xueshuan Xinmaining tablet combined with metoprolol exhibit remarkable therapeutic effects on patients with coronary heart disease subjected to percutaneous coronary intervention. The combined therapy can greatly reduce inflammatory reaction and decrease creatine kinase-MB level and improve vascular endothelial function.
RESUMO
Objective:To investigate myocardial fibrosis-related factors in patients with hypertrophic cardiomyopathy.Methods:Ninety-six patients with hypertrophic cardiomyopathy who received treatment in Zhoushan Hospital between January 2019 and January 2021 were included in this study. General data of all patients were collected. Cardiovascular magnetic resonance imaging was performed in all patients. Percentage of late gadolinium enhancement (LGE) was calculated. These patients were divided into positive and negative groups according to whether myocardial fibrosis existed. Related parameters were compared between the two groups. Correlations between related parameters and myocardial fibrosis range were analyzed.Results:Patient age in the positive group was significantly lower than that in the negative group [(42.84 ± 14.38) years vs. (50.71 ± 14.74) years, t = 2.04, P < 0.05]. The percentage of patients with New York Heart Association (NYHA) class III/IV heart function, N-terminal pro-brain natriuretic peptide (NT-proBNP) level, cardiac troponin (cTnI) level, creatine kinase-MB level, and myoglobin level in the positive group were 29.41% (20/68), 2 761.73 (1 505.22, 3 784.62) ng/L, 0.971 (0.447, 1.687) μg/L, (3.25 ± 2.65) μg/L and (66.14 ± 31.17) μg/L, respectively, which were significantly higher than those in the negative group [3.57% (1/68), 862.35 (551.48, 1 094.83) ng/L, 0.146 (0.037, 0.256) μg/L, (0.73 ± 0.22) μg/L, (28.82 ± 2.34) μg/L, t = 12.17, 55.28, 3.17, 5.18, 8.18, all P < 0.05]. Left ventricular ejection fraction and cardiac index in the positive group were (62.31 ± 17.89)% and (2.85 ± 0.71) L·min -1·(m 2) -1, respectively, which were significantly lower than those in the negative group ( t = 2.89, 6.18, both P < 0.05). Left ventricular end-diastolic volume (LVEDV), left ventricular maximum wall thickness (LVMWT) and left ventricular mass index (LVMI) in the positive group were (56.32 ± 17.28) mL/m 2, (2.24 ± 0.41) cm, (126.15 ± 12.34) g/m 2, which were significantly higher than those in the negative group ( t = 2.17, 2.75, 13.10, all P < 0.05). In the positive group, 18 patients had moderate and severe hypertrophy, 20 patients had moderate hypertrophy, and 30 patients had mild hypertrophy. There were significant differences in NT-proBNP, cTnI level and (LGE) extent between positive and negative groups ( t = 43.27, 5.28, 11.18, all P < 0.05). NT-proBNP, cTnI level and LGE extent increased with the increase in hypertrophy. Percentage of LGE was negatively correlated with patient age, and it was positively correlated with NT-proBNP, cTnI, LVDSV, LVMWT and LVMI. The differences were statistically significant (all P < 0.05). Conclusion:Patients with hypertrophic cardiomyopathy have a relatively high incidence of myocardial fibrosis. The extent of myocardial fibrosis is negatively correlated with patient age and it is positively correlated with NT-proBNP, cTnI, LVDSV, LVMWT and LVMI.
RESUMO
Objective To study application effectiveness of different concentrations of chlorhexidine oral care solu-tion in patients with orotracheal intubation.Methods A total of 120 patients who were admitted to the general in-tensive care unit (ICU)of a hospital and undergoing mechanical ventilation via orotracheal intubation for >48 hours between January 2012 and December 2013 were included in the study,they were divided randomly into three groups,40 in each group.Trial group,control group I,and control group II were provided with 2%,0.2%,and 0.12% chlorhexidine oral care solution,respectively.Differences in halitosis,oral mucosal infection,onset time and incidence of ventilator-associated pneumonia (VAP ) among three groups were observed and compared. Results There were significant difference in incidence of VAP and early-onset VAP between trial group and control group I,trial group and control group II,respectively(both P <0.05 );incidence of VAP in control group II was higher than trial group(47.50% vs 20.00%,P =0.009).Conclusion 2% chlorhexidine oral rinsing and swabbing can effectively reduce incidence of VAP in patients with orotracheal intubation.