摘要
目的观察缬沙坦在老年心脏瓣膜病治疗中的应用效果。方法选择2015年1月—2016年7月老年心脏瓣膜病患者90例,随机分为对照组和观察组各45例。对照组采用常规方法对症治疗,观察组在对照组基础上联合缬沙坦口服治疗,每天早晨40 mg,1次/d,根据患者耐受每1~2周剂量加倍,最大剂量每天不得超过120 mg,长期维持,连续治疗6个月。治疗前、治疗后6个月采用超声测定两组心功能指标:射血分数(ejection fraction,EF)、左心室缩短分数(left ventricular fractional shortening,FS)及左心室舒张期内径(left ventricular diastolic diameter,LVDD),检测成纤维细胞生长因子23(fibroblast growth factor23,FGF-23)、Klotho蛋白水平,记录治疗期间发生的不良反应。计量资料比较采用t检验,计数资料比较采用χ~2检验,P<0.05为差异有统计学意义。结果两组治疗前EF、FS及LVDD比较差异无统计学意义(均P>0.05);疗后6个月观察组EF、FS及LVDD分别为[(63.26±3.12)%、(31.25±3.91)%及(3.13±0.44)mm]低于对照组[(66.31±4.01)%、(33.51±4.26)%及(3.20±0.41)mm](均P<0.05)。两组治疗前FGF23、Klotho蛋白水平比较差异无统计学意义(均P>0.05);治疗6个月,观察组FGF23蛋白水平[(35.31±8.29)ng/L]低于对照组[(78.47±10.91)ng/L],Klotho蛋白水平[(172.31±11.49)U/L]高于对照组[(153.26±10.91)U/L](均P<0.05)。两组不良反应发生率比较差异无统计学意义(P>0.05)。结论老年心脏瓣膜病患者缬沙坦治疗可提高血清Klotho蛋白水平,降低FGF23蛋白水平。
Objective To observe the effect of valsartan on senile heart valvular disease. Methods From January 2015 to July 2016, 90 elderly patients with valvular heart disease were randomly divided into control group and observation group. The patients in the control group were given symptomatic treatment by conventional method. The observation group was treated with oral valsartan on the basis of the control group. The oral dose was 40 mg per day in the morning and doubled every 1-2 weeks according to patient tolerance. The maximum dose should not exceed 120 mg per day, Long-term maintenance, continuous treatment for 6 months （1 course）. Before and 6 months after treatment, heart function parameters （Ejection fraction, EF, Left ventricular fractional shortening, Left ventricular diastolic diameter and left ventricular diastolic diameter） were measured by uhrasonography, LVDD）. The levels of fibroblast growth factor 23 （FGF-23） and Klotho protein were detected and the adverse events were recorded. Measurement data uses t test,and count data uses x^2 test, P〈0.05 is considered statistically significant. Results EF, FS and LVDD were not significantly different between the two groups before treatment （all P〉0.05）; EF, FS and LVDD of the observation group [（63.26 ± 3.12）%, （31.25 ± 3.91）% and （3.13 ± 0.44）mm] were significantly lower than those in the control group[（66.31 ±4.01）%,（33.51 ±4.26）% and （3.20± 0.41）mm] （all P〈0.05）. There was no significant difference in the levels of FGF23 and Klotho between the two groups （P〉0.05）. After 6 months of treatment, the levels of FGF23 [（35.31 ±8.29）ng/L]in the observation group were lower than those in the control group [（78.47± 10.91）ng/L], Klotho protein level [（172.31 ± 11.49）U/L] was higher than that of the control group [（153,26± 10.91）U/L]（all P〈0.05）. There was no significant difference in the incidence of adverse reactions between the two groups（P〉0.05）. Conclusion Valsartan treatm
出处
《社区医学杂志》
2017年第4期9-11,共3页
Journal Of Community Medicine
