参仙升脉口服液联合曲美他嗪对缓慢性心律失常患者外周血单个核细胞中cAMP/PKA信号通路相关蛋白水平的影响

摘要 目的：观察缓慢性心律失常（BA）经参仙升脉口服液联合曲美他嗪治疗4周后的临床疗效及对外周血单个核细胞中环磷酸腺苷( cAMP) /蛋白激酶A（PKA）信号通路相关蛋白水平的影响。方法：将2017年8月~2020年8月期间我院收治的126例BA患者随机分为两组，对照组和观察组，各63例。对照组接受曲美他嗪治疗，观察组接受参仙升脉口服液联合曲美他嗪治疗，观察并对比两组24 h动态心电图指标（最慢心率、静息状态下心率、24 h平均心率）、心功能指标左室射血分数(LVEF)、心输出量(CO)、心脏指数(CI)]、疗效、外周血单个核细胞中cAMP/PKA信号通路相关蛋白（cAMP蛋白、PKA蛋白）水平及不良反应。结果：观察组的临床总有效率90.48%（57/63）高于对照组的71.43%（45/63），差异有统计学意义（P<0.05）。治疗4周后，与对照组比较，观察组静息状态下心率、24 h平均心率、最慢心率均较高（P<0.05）。治疗4周后，观察组LVEF、CO、CI高于对照组（P<0.05）。治疗4周后，观察组外周血单个核细胞中cAMP蛋白、PKA蛋白水平高于对照组（P<0.05）。两组不良反应发生率组间对比无差异（P>0.05）。结论：参仙升脉口服液联合曲美他嗪治疗BA患者，可改善治疗效果，促进24h动态心电图、心功能指标改善，其主要作用机制可能与调节cAMP/PKA信号通路相关蛋白表达有关。

Effect of Shenxianshengmai Oral Liquid Combined with Trimetazidine on the Levels of cAMP/PKA Signaling Pathway Related Proteins in Peripheral Blood Mononuclear Cells of Patients with Bradyarrhythmia

ABSTRACT Objective: To observe the clinical efficacy of Shenxian Shengmai oral liquid combined with trimetazidine in the treatment of bradyarrhythmia (BA) for 4 weeks after treatment and its effect on the levels of cyclic adenosine phosphate (cAMP)/protein kinase A (PKA) signaling pathway related proteins in peripheral blood mononuclear cells. Methods: 126 BA patients in our hospital from August 2017 to August 2020 were randomly divided into two groups, the control group and the observation group, 63 cases in each group. The control group was treated with trimetazidine, and the observation group was treated with Shenxian Shengmai oral liquid combined with trimetazidine. The 24-hour dynamic electrocardiogram indexes (slowest heart rate, resting heart rate, 24 h average heart rate), cardiac function indexes left ventricular ejection fraction (LVEF), cardiac output (CO), cardiac index (CI)], curative effect, cAMP / PKA signal pathway related protein (cAMP protein, PKA protein) levels and adverse reactions of the two groups were observed and compared. Results: The total effective rate of the observation group was 90.48% (57 / 63), which was higher than 71.43% (45 / 63) of the control group, the difference was statistically significant (P<0.05). 4 weeks after treatment, compared to the control group, the resting heart rate, 24 h average heart rate and slowest heart rate of the observation group were higher (P<0.05). 4 weeks after treatment, the LVEF, CO and CI of the observation group were higher than those of the control group (P<0.05). 4 weeks after treatment, cAMP protein and PKA protein in peripheral blood mononuclear cells of the observation group were higher than those of the control group (P<0.05). There was no difference in the incidence of adverse reactions between the two groups (P>0.05). Conclusion: Shenxian Shengmai oral liquid combined with trimetazidine in the treatment of BA patients can improve the therapeutic effect, promote the improvement of 24-hour dynamic electrocardiogram and cardiac function indexes, and its main mechanism may be related to the regulation of cAMP / PKA signal pathway related protein expression.