摘要
目的观察血清炎性因子水平与慢性充血性心力衰竭并阻塞性睡眠呼吸暂停综合征(OSAS)患者室性心律失常的关系,并探讨稳心颗粒在室性心律失常治疗中的作用及机制。方法 60例慢性充血性心力衰竭并OSAS患者随机分为对照组及试验组,每组30例。2组均予以常规抗心力衰竭治疗,试验组加用稳心颗粒,共治疗90 d。治疗前及治疗后评估2组患者左心功能、AHI,计算室性心律失常评分,并检测血清炎性因子水平及HRV各参数。结果血清白介素-17(IL-17)、肿瘤坏死因子-α(TNF-α)、超敏C-反应蛋白(hs-CRP)、血管紧张素Ⅱ(AngⅡ)水平与室性心律失常评分成正相关(P <0. 05),而ET-1水平与之不相关(P> 0. 05)。治疗后,2组左心功能均较治疗前提高(P <0. 05),室性心律失常评分及血清IL-17、TNF-α、hs-CRP、AngⅡ水平均较治疗前明显下降(P <0. 05),其中室性心律失常评分、IL-17、TNF-α、AngⅡ以试验组下降更为显著(P <0. 05); 2组ET-1水平治疗前后比较,差异无统计学意义(P> 0. 05)。与治疗前比较,2组HRV参数RMSSD、PNN50%均明显上升(P <0. 05),以试验组上升更为显著(P <0. 05),HRV参数SDNN、SDANN差异均无统计学意义(P> 0. 05)。结论血清IL-17、TNF-α、hs-CRP、AngⅡ水平与室性心律失常的发生密切相关,稳心颗粒可减少室性心律失常的发生,其机制与降低血清IL-17、TNF-α、AngⅡ水平,改善迷走神经张力有关。
Objective To investigate the relationship between serum inflammatory factors levels and ventricular arrhythmia in patients with chronic congestive cardiac failure complicated by obstructive sleep apnea syndrome (OSAS), and to explore the effects and mechanism of Wenxin granule in treatment of ventricular arrhythmia. MethodsA total of 60 patients with chronic congestive cardiac failure complicated by OSAS were randomly divided into control group ( n =30) and experimental group ( n =30). The patients in both groups were treated by conventional anti-heart failure drugs, on this basis, the patients in experimental group were treated by oral Wenxin granule,with a treatment course of 90 days for both groups. The left heart function, apnea hyponea index (AHI), ventricular arrhythmia scores, the serum levels of inflammatory factors and heart rate variability (HRV) indexes were detected before and after treatment. ResultsThe serum levels of interleukin 17 (IL-17), tumor necrosis factor α(TNF-α), hypersensitivity C reactive protein (hs-CRP) and angiotensin Ⅱ(Ang Ⅱ) were positively correlated with ventricular arrhythmia scores ( P <0.05), however the serum levels of (ET-1) were not correlated with ventriculatr arrhythmia scores ( P >0.05). After treatment the left heart function in both groups was significantly improved,as compared with that before treatment ( P <0.05.) The scores of ventricular arrhythmia and serum levels of IL-17, TNF-α, hs-CRP and Ang Ⅱ in both groups were significantly decreased,as compared with those before treatment ( P < 0.05 ). Moreover the decrease degrees of ventricular arrhythmia, IL-17, TNF-α, Ang Ⅱ in experimental group was more significant than that in control group ( P <0.05). There were no significant differences in the serum levels of ET 1 before and after treatment between two groups ( P >0.05). After treatment the parameters of HRV including RMSSD, PNN50% were significantly increased in both groups, as compared with those before treatment ( P <0.05), moreover ,the increase deg
作者
赖晓峰
刘文
LAI Xiaofeng;LIU Wen(Department of Cardiology,General Hospital of Chonggang Group, Chongqing 400000,China)
出处
《河北医药》
CAS
2019年第1期19-23,共5页
Hebei Medical Journal