摘要
目的观察替米沙坦对缺血性心肌病病人临床血生化指标及血浆同型半胱氨酸(Hcy)、颈动脉内膜中层厚度(IMT)的影响。方法将60例血压正常的缺血性心肌病病人按随机数字表法分为替米沙坦组和常规治疗组,各30例。比较入选两组临床资料,测定相关生化指标。比较血清同型半胱氨酸及心钠素水平。超声诊断仪测定两组左房内径、左室舒末内径及左室射血分数;颈动脉血管走向、管壁、管径、内中膜厚度及有无斑块形成,两组均给予常规治疗,替米沙坦组另给予替米沙坦40 mg/d,疗程为24周。比较两组治疗前和治疗12周、24周后心钠素、血浆Hcy水平、心脏射血分数及颈动脉IMT的变化。结果治疗后,替米沙坦组与常规治疗组比较血浆Hcy水平[(14.69±3.98)μmol/L vs(16.98±4.35)μmol/L]显著下降(P<0.05),心钠素(BNP)水平下降[(138±43)pg/m L vs(168±34)pg/m L]。替米沙坦组治疗后较治疗前颈动脉IMT[(0.91±0.14)mmvs(0.98±0.15)mm]显著降低(P<0.05)。结论替米沙坦能改善缺血性心肌病病人心衰症状,降低血浆Hcy和心钠素BNP水平及颈动脉IMT,提高射血分数,具有独立于降压之外的心脏保护作用,并能延缓动脉粥样硬化进展,改善缺血性心肌病病人生存质量。
Objective To observe the effects of telmisartan on blood biochemical indicators,plasma homocysteine（ Hcy） and carotid intimamedia thickness（ IMT） in patients with ischemic cardiomyopathy. Methods Sixty patients with normal blood pressure of ischemic cardiomyopathy according to random number table method were randomly divided into two groups： The control group（n = 30） treated with routine treatment,and the treatment group（ n = 30） treated with routine treatment plus telmisartan for 24 weeks. The biochemical indicators,B-type natriuretic peptide（ BNP） levels and plasma Hcy levels were tested after 12 and 24 weeks of treatment. The heart ejection fraction and the changes of carotid IMT were observed. Results After treatment,the levels of plasma Hcy and BNP in treatment group were lower than that in control group[（ 14. 69 ± 3. 98） μmol / L vs（ 16. 98 ± 4. 35） μmol / L,P〈0. 05;（ 138 ± 43） pg / m L vs（ 168 ± 34） pg / m L,P〈0. 05]. After treatment,carotid IMT was decreased in treatment group[（ 0. 91 ±0. 14） mm vs（ 0. 98 ± 0. 15） mm,P〈0. 05]. Conclusion Telmisartan can improve symptoms of heart failure in patients with ischemic cardiomyopathy,lower plasma Hcy,BNP levels and carotid IMT,and improve ejection fraction,delay the progress of atherosclerosis,improve quality of life in patients with ischemic cardiomyopathy.
出处
《中西医结合心脑血管病杂志》
2016年第5期463-465,共3页
Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease
关键词
缺血性心肌病
心悸
替米沙坦
血浆同型半胱氨酸
颈动脉内膜中层厚度
心钠素
telmisartan
ischemic cardiomyopathy
plasma homocysteine
carotid intima-media thickness Yang CuiThe Second Affiliated Hospital of Shenyang Medical College,Shenyang 110002,Liaoning,China
