摘要
目的:研究托伐普坦与布美他尼治疗缺血性心肌病疗效及对患者基质金属蛋白酶-2(MMP-2)、基质金属蛋白酶组织抑制因子(TIMP-1)水平和心功能的影响。方法:将2016年10月至2019年4月南阳医学高等专科学校第一附属医院80例缺血性心肌病患者,按照随机数字表法均分为托伐普坦组(托伐普坦治疗)和布美他尼组(布美他尼治疗),每组40例。比较两组患者治疗效果,记录治疗前、治疗1周后MMP-2及TIMP-1、心功能[左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)、左心室射血分数(LVEF)]、24 h尿量、疾病相关因子[半乳糖凝集素-3(Gal-3)、分形趋化因子(FKN)]水平。结果:治疗1周后,两组治疗总有效率比较,差异未见统计学意义(P>0.05)。治疗1周后,两组患者MMP-2、LVEDD、LVESD、疾病相关因子(Gal-3、FKN)水平均较治疗前下降,托伐普坦组低于布美他尼组(P<0.05);两组患者TIMP-1、LVEF、24 h尿量水平较治疗前上升,托伐普坦组高于布美他尼组(P<0.05)。结论:托伐普坦与布美他尼治疗缺血性心肌病的疗效均显著,托伐普坦相较于布美他尼,能更好地改善心功能、提升尿量。
Objective To explore the efficacy of tolvaptan and bumetanide in the treatment of ischemic cardiomyopathy and its effects on levels of matrix metalloproteinase-2(MMP-2)and tissue inhibitor of metalloproteinase(TIMP-1)and cardiac function.Methods Eighty patients with ischemic cardiomyopathy in the First Affiliated Hospital of Nanyang Medical College from October 2016 to April 2019 were divided into tolvaptan group(given tolvaptan treatment)and bumetanide group(given bumetanide treatment)according to the random number table method,40 cases in each group.The treatment effects of the two groups were compared.The MMP-2 and TIMP-1,cardiac function[left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction(LVEF)],24 h urine volume and disease-related factors[galectin-3(Gal-3),fractalkine(FKN)]were recorded before treatment and after 1 week of treatment.Results After 1 week of treatment,there was no significant difference in the total effective rate between the two groups(P>0.05).After 1 week of treatment,the levels of MMP-2,LVEDD,LVESD and disease-related factors(Gal-3,FKN)in the two groups were significantly increased compared with those before treatment,and the levels in tolvaptan group were significantly lower than those in bumetanide group(P<0.05).The TIMP-1,LVEF and 24 h urine volume in the two groups were significantly increased compared with those before treatment,and the indexes in tolvaptan group were significantly higher than those in bumetanide group(P<0.05).Conclusions Both tolvaptan and bumetanide have significant efficacy in the treatment of ischemic cardiomyopathy.Compared with bumetanide,tolvaptan have a better effect on improving cardiac function and increasing urine volume.
作者
张琮
赵佩
张占海
Zhang Cong;Zhao Pei;Zhang Zhanhai(Special Ward,the First Affiliated Hospital of Nanyang Medical College,Nanyang 473000,China)
出处
《中国实用医刊》
2020年第12期97-100,共4页
Chinese Journal of Practical Medicine
