标题：银杏叶滴丸联合单硝酸异山梨酯注射液对老年冠心病患者心肌酶谱及血清BNP水平的影响

      作者：王荣 1，李慧 2，秦建宁 3    1.西安工会医院老年病科，陕西 西安 710065；2.空军第九八六医院心内科，陕西 西安 710065；3.西安市第三医院心内科，陕西 西安 710065

      卷次： 2019年30卷18期

      【摘要】 目的 探讨银杏叶滴丸联合单硝酸异山梨酯注射液在冠心病老年患者中的应用价值。方法 选取西安工会医院2017年11月至2018年10月收治的冠心病老年患者106例为研究对象，按随机数表法将患者分为对照组和观察组，每组53例。对照组患者在常规治疗基础上采取单硝酸异山梨酯注射液治疗，观察组患者则在对照组治疗的基础上加用银杏叶滴丸治疗，疗程均为两周。比较两组患者的临床疗效、治疗前及治疗两周后的炎性因子[白细胞介素-2 (IL-2)、肿瘤坏死因子-α (TNF-α)]及B型脑钠肽(BNP)、心肌酶谱指标[肌酸激酶同工酶(CK-MB)、肌酸激酶(CK)、天门冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)]、心功能指标[左心室射血分数(LVEF)、心脏指数(CI)]水平和不良反应。结果 观察组患者的治疗总有效率为94.34%，明显高于对照组的81.13%，差异有统计学意义(P<0.05)；两组患者治疗两周后的CK-MB、CK、AST、LDH水平较治疗前明显降低，且观察组患者治疗后的上述心肌酶谱指标指标明显低于对照组，差异均有统计学意义(P<0.05)；两组患者治疗两周后的BNP、IL-2、TNF-α较治疗前明显降低，且观察组患者治疗后的炎性因子和BNP水平明显低于对照组，差异均有统计学意义(P<0.05)；两组患者治疗2周后的LVEF、CI较治疗前明显增高，且观察组患者治疗后的LVEF为(58.37±5.59)%、CI为(3.21±0.46) L/(min·m2)，明显高于对照组的(52.71±5.31)%、(2.39±0.43) L/(min·m2)，差异均有统计学意义(P<0.05)；观察组患者治疗期间的不良反应发生率为13.21%，略高于对照组的9.43%，但差异无统计学意义(P>0.05)。结论 联合采取单硝酸异山梨酯注射液及银杏叶滴丸治疗老年冠心病可纠正患者异常心肌酶谱，减少血清炎性因子含量，抑制体内炎性反应程度，恢复患者心功能，提高疾病整体治疗疗效，且不会增加不良反应发生风险，具有安全性。
      【关键词】 银杏叶滴丸；单硝酸异山梨酯注射液；冠心病；心肌酶谱；BNP；心功能；安全性
      【中图分类号】 R541.4 【文献标识码】 A 【文章编号】 1003—6350（2019）18—2349—05

Effects of Ginkgo biloba drop pills combined with isosorbide mononitrate injection on myocardial enzymes andserum BNP levels in elderly patients with coronary heart disease.
WANG Rong 1, LI Hui 2, QIN Jian-ning 3. 1.Department of Geriatrics, Xi'an Trade Union Hospital, Xi'an 710065, Shaanxi, CHINA; 2. Department of Cardiology, AirForce 986 Hospital, Xi'an 710065, Shaanxi, CHINA; 3. Department of Cardiology, the Third Hospital of Xi'an, Xi’an710065, Shaanxi, CHINA
【Abstract】 Objective To investigate the application value of Ginkgo biloba drop pills combined with isosor-bide mononitrate injection in elderly patients with coronary heart disease. Methods A total of 106 elderly patients withcoronary heart disease, who admitted to Xi'an Trade Union Hospital from November 2017 to October 2018, were select-ed and divided into the control group and observation group according to random number table method, with 53 cases ineach group. On the basis of conventional treatment, isosorbate mononitrate injection was used in the control group, andthe observation group was given Ginkgo biloba drop pills on the basis of the control group, all for 2 weeks. The clinicalefficacy, inflammatory factors (interleukin-2 [IL-2], tumor necrosis factor-α [TNF-α]), B-type brain natriuretic peptide(BNP), myocardial enzymes indicators (creatine kinase isoenzyme [CK-MB], creatine kinase [CK], aspartate aminotrans-ferase [AST], lactate dehydrogenase [LDH]), cardiac function index (left ventricular ejection fraction [LVEF], cardiac in-dex [CI]) level before treatment and 2 weeks after treatment, and adverse reactions of the two groups were counted andcompared. Results The total effective rate of the observation group was 94.34% versus 81.13% of the control group(P<0.05). The levels of CK-MB, CK, AST, and LDH in the two groups two weeks after treatment were significantly low-er than those before treatment, and the above-mentioned indicators in the observation group after treatment were also sig-nificantly lower than those in the control group (all P<0.05). The levels of BNP, IL-2 and TNF-α in the two groups twoweeks after treatment were lower than those before treatment, and the levels of BNP, IL-2 and TNF-α in the observationgroup after treatment were also significantly lower than those in the control group (all P<0.05). After 2 weeks of treat-ment, the levels of LVEF and CI in the two groups were significantly higher than those before treatment, and the levelsof LVEF and CI in the observation group after treatment were (58.37±5.59)% and (3.21±0.46) L/(min·m2), respectively,which were significantly higher than corresponding (52.71±5.31)% and (2.39±0.43) L/(min·m2) in the control group (all