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补益强心片联合曲美他嗪对老年慢性心力衰竭患者疗效的影响

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摘要:

目的 探讨补益强心片联合曲美他嗪治疗老年慢性心力衰竭(CHF)的临床疗效及对血管活性物质和炎性因子的影响。方法 选取2019年1月至2020年6月于商丘市立医院内科收治的152例老年CHF患者,随机分为对照组和观察组,每组各76例,对照组给予曲美他嗪治疗,观察组在对照组基础上联合补益强心片,均连续治疗4周。治疗后,比较两组患者心功能指标[左室射血分数(LVEF)、心输出量(CO)、6 min步行试验(6-MWT)及血浆脑钠肽(BNP) 水平]、心室重构指标[左室心肌质量指数(LVMI)、左室平均室壁应力(MWS)]、血管活性物质[血管型血友病因子(vWF)、内皮素-1(ET-1)、一氧化氮(NO)、6-酮-前列腺素F1α]和炎性因子[肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、半乳糖凝集素-3(G-3)、C-反应蛋白(CRP)]的变化及不良反应。结果 两组患者治疗后心功能指标、心室重构指标、血管活性物质、炎性因子均较治疗前有所改善(P<0.05)。治疗后,观察组心功能指标LVEF、CO和6-MWT明显高于对照组(P<0.05),BNP水平明显低于对照组(P<0.05);观察组心室重构指标LVMI和MWS明显低于对照组(P<0.05);炎性因子TNF-α、IL-6、G-3、CRP水平明显低于对照组(P<0.05);观察组血管活性物质vWF、ET-1水平明显低于对照组(P<0.05),NO、6-酮-前列腺素F1α水平明显高于对照组(P<0.05);两组患者不良反应总发生率差异无统计学意义(P>0.05)。结论 补益强心片联合曲美他嗪治疗老年CHF疗效较好,可有效改善心功能,延缓心室重构,调节血管活性物质和炎性因子水平,安全性较高。

Abstract:

Objective To discuss the influence of Buyi Qiangxin Tablets combined with trimetazidine on clinical efficacy, vasoactive substances and inflammatory factors in elderly patients with chronic heart failure (CHF). Methods Elderly CHF patients (n=152) were chosen from Department of Internal Medicine in Shangqiu Municipal Hospital from Jan. 2019 to June 2020, and divided randomly into control group and observation group (each n=76). The control group was treated with trimetazidine, and observation group was treated with trimetazidine combined with Buyi Qiangxin Tablets for 4 weeks. After treatment, the changes of indexes of heart function [left ventricular ejection fraction (LVEF), cardiac output (CO), 6-minute walk test (6MWT), brain natriuretic peptide (BNP)], indexes of ventricular remodeling [left ventricular mass index (LVMI), left ventricular mean wall stress (MWS)], vasoactive substances [vascular Willebrand factor (vWF), endothelin-1 (ET-1), nitric oxide (NO), 6-keto-prostaglandin F1α (6-keto-PGF1α)], inflammatory factors [tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6), galectin-3 (Gal-3), C-reactive protein (CRP)] and adverse reactions were compared between 2 groups. Results The indexes of heart function, indexes of ventricular remodeling, vasoactive substances and inflammatory factors were improved in 2 groups after treatment (P<0.05). After treatment, LVEF, CO and 6-MWT were significantly higher (P<0.05) and BNP level was significantly lower (P<0.05) in observation group than those in control group. LVMI and MWS were significantly lower (P<0.05), and levels of TNF-α, IL-6, Gal-3 and CRP were significantly lower in (P<0.05) in observation group than those in control group. The levels of vWF and ET-1 were significantly lower (P<0.05), and levels of NO and 6-keto-PGF1α were significantly higher (P<0.05) in observation group than those in control group. The difference in incidence rates of adverse reactions had no statistical significance (P>0.05) between 2 groups. Conclusion Buyi Qiangxin Tablets combined with trimetazidine has a higher curative effect in elderly CHF patients, and it can effectively improve heart function, delay ventricular remodeling and regulate levels of vasoactive substances and inflammatory factors with higher safety.

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