摘要
目的探讨沙库巴曲缬沙坦(诺欣妥)治疗高龄冠心病合并心力衰竭患者的疗效及对心室重塑、血管内皮功能及胰岛素样生长因子-1(IGF-1)、可溶性生长刺激表达基因2(sST2)蛋白的影响。方法将122例冠心病合并心力衰竭患者按照随机数字表法分为研究组和对照组,每组61例。对照组严格按照指南指导方案治疗,研究组采用诺欣妥联合指南指导方案治疗。比较2组患者治疗前后的心功能和左室射血分数(LVEF)、左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)、舒张期室间隔厚度(IVST)、舒张期左室后壁厚度(LVPWT)、左室质量指数(LVMI)和血清神经内分泌激素及N端前脑钠肽(NT-pro BNP)的变化;比较2组患者治疗前后血管内皮功能相关指标一氧化氮(NO)、一氧化氮合酶(NOS)、白细胞介素-6(IL-6)及IGF-1、sST2蛋白表达水平变化及治疗期间的不良反应。结果研究组治疗有效率为96.7%,显著高于对照组的83.6%(P<0.05);治疗前2组LVEF、LVESV、LVEDV、IVST、LVMI和LVPWT比较差异均无统计学意义,治疗后,研究组LVEF、LVMI比对照组显著提高,LVESV、LVEDV、IVST和LVPWT比对照组显著降低(P<0.05)。2组患者治疗前NO、NOS和sST2比较差异均无统计学意义,治疗后2组患者IGF-1、NO和NOS明显提高,研究组表达水平高于对照组(P<0.05),IL-6、NT-pro BNP和sST2明显降低,且研究组表达水平明显低于对照组(P<0.05)。结论诺欣妥联合指南指导方案治疗冠心病合并心力衰竭患者可改善心室重塑,提高患者心功能,提高血管内皮功能和IGF-1,降低NT-pro BNP、sST2表达,保护心血管系统。
Objective To explore the effect of Sacubitril Valsartan Sodium Tablets(Entresto)on ventricular remodeling,vascular endothelial function,insulin-like growth factor-1(IGF-1),and soluble growth stimulation expressed gene 2(sST2)in elderly patients with coronary heart disease and heart failure.Methods 122 patients with coronary heart disease and heart failure were enrolled and randomly divided into control group and observation group,61 cases in each group.The control group were given the guidelines guide drug treatment(GDMT),while the observation group received Entresto on the basis of control group.The changes of left ventricular ejection fraction(LVEF),left ventricular end systolic volume(LVESV),left ventricular end diastolic volume(LVEDV),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular mass index(LVMI)and amino-terminal pro brain natriuretic peptide(NT-pro BNP)were observed.The changes of nitric oxide(NO),nitric oxide synthase(NOS),interleukin-6(IL-6),IGF-1 and sST2 protein expression levels and adverse reactions during treatment were compared between the 2 groups.Results The effective rate of the observation group(96.7%)was significantly higher than that of the control group(83.6%)(P<0.05).After treatment,the LVEF and LVMI in the observation group were significantly higher than in the control group(P<0.05);the LVESV,LVEDV,IVST and LVPWT in the observation group were significantly lower than in the control group(P<0.05);the IGF-1,NO and NOS in the observation group were significantly higher than in the control group(P<0.05);IL-6,NT-pro BNP,sST2 in the observation group were significantly lower than in the control group(P<0.05).Conclusion The implementation of GDMT with Entresto can effectively improve the cardiac function,reverse the cardiac remodeling,improve the expression of IGF-1,and reduce the expression of sST2.
作者
吴丹娜
陈朝聪
徐文娟
胡浪
余华军
WU Danna;CHEN Chaocong;XU Wenjuan;HU Lang;YU Huajun(Department of Pharmacy,Danzhou People's Hospital,Danzhou 571700,China;Department of Pharmacy,the Second Affiliated Hospital of Hainan Medical University,Haikou 570216,China;Department of Pathology,Danzhou People's Hospital,Danzhou 571700,China)
出处
《西北药学杂志》
CAS
2022年第2期126-130,共5页
Northwest Pharmaceutical Journal
基金
海南省卫生计生行业科研项目(编号:13A200032)。
