摘要
目的探讨伊伐布雷定联合左西孟旦注射液对慢性心力衰竭(慢性心衰)患者的临床应用价值。方法随机抽取166例慢性心衰患者作为研究对象,将患者随机分为2组,每组83例。对照组用左西孟旦注射液治疗,观察组在对照组治疗的基础上加用伊伐布雷定。于用药前后评估患者的生活质量[明尼苏达心功能不全生活质量量表评分(MLHFQ)]和运动耐量[6 min步行试验(6MWT)],超声心动图检测二尖瓣最大流速(E)/心房收缩期二尖瓣血流最大流速(A)(E/A)、每搏输出量(SV)、心输出量(CO)和左室射血分数(LEVF)心功能指标,测定血清结缔组织生长因子(CTGF)、基质金属蛋白酶-2(MMP-2)、转化生长因子-β_(1)(TGF-β_(1))、Ⅰ型胶原交联羧基末端肽(ICTP)、透明质酸(HA)和Ⅲ型前胶原氨基末端肽(PⅢNP)6项心肌纤维标志物水平,同时检测肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)和超敏C反应蛋白(hs-CRP)3项炎症指标,记录不良反应。结果观察组治疗总有效率显著优于对照组(96.39%vs.86.75%),P<0.05。2组患者用药后MLHFQ评分均较用药前降低,6MWT延长(P<0.05),用药后观察组MLHFQ评分和6MWT指标改善优于对照组(P<0.05)。2组患者用药后LVEF、SV、CO和E/A均较用药前提高(P<0.05),观察组LVEF、SV、CO和E/A明显高于对照组(P<0.05)。2组患者用药后CTGF、TGF-β_(1)、MMP-2、HA、ICTP和PⅢNP均降低(P<0.05),且观察组明显低于对照组(P<0.05)。2组用药后TNF-α、IL-6和hs-CRP水平较用药前均降低(P<0.05),观察组用药后炎性因子水平较同期对照组更低(P<0.05)。观察组不良反应发生率(7.23%)与对照组(6.02%)比较,差异无统计学意义(P>0.05)。结论伊伐布雷定联合左西孟旦注射液治疗慢性心衰患者可取得理想的临床效果,能提高运动耐量,改善心功能,抑制心肌纤维化,减轻炎症反应,患者生活质量明显提高,用药安全。
Objective To explore the clinical application value of ivabradine combined with Levosimendan Injections in patients with chronic heart failure.Methods 166 patients with chronic heart failure were randomly selected as subjects,and the patients were randomly divided into 2 groups,with 83 cases in each group.The control group were treated with Levosimendan Injections,while the observation group were treated with ivabradine on the basis of control group.The treatment effect,the quality of life[Minnesota Cardiac Insufficiency Quality of Life Scale(MLHFQ)]and the exercise tolerance[6 minutes walk test(6MWT)]of the 2 groups before and after medication were evaluated.The maximum mitral valve flow rate(E)/the maximum flow rate of mitral valve blood flow(A)(E/A)detected by echocardiography,stroke volume(SV),cardiac output(CO)and left ventricular ejection fraction(LEVF)cardiac function indicators,the serum connective tissue growth factor(CTGF),mechanism metalloproteinase-2(MMP-2),transforming growth factor-β_(1)(TGF-β_(1)),type Ⅰ collagen cross-linked carboxyl terminal peptide(ICTP),hyaluronic acid(HA),type Ⅲ procollagen amino terminal peptide(PⅢNP)levels of 6 myocardial fiber markers,tumor necrosis factor(TNF-α),interleukin-6(IL-6)and high sensitivity C-reactive protein(hs-CRP)3 inflammation indicators were simultaneously detected.The adverse reactions were also recorded and compared.Results The total effective rate of observation group was significantly better than that of control group(96.39%vs.86.75%)(P<0.05).The MLHFQ scores of the 2 groups of patients after medication were lower than before medication,and 6MWT was prolonged(P<0.05).Compared with the control group after medication,the improvement of MLHFQ score and 6MWT indicators in the observation group was better than that in the control group(P<0.05).The LVEF,SV,CO,and E/A of the 2 groups of patients were all higher than before treatment(P<0.05),and the LVEF,SV,CO and E/A standards of the observation group were significantly higher than those of the contro
作者
李敏
齐爽
远敏杰
梅松柳
LI Min;QI Shuang;YUAN Minjie;MEI Songliu(Mudanjiang Medical College,Mudanjiang 157011,China;Department of Geriatrics,Red Flag Hospital Affiliated to Mudanjiang Medical College,Mudanjiang 157000,China;Department of Neurology,Red Flag Hospital Affiliated to Mudanjiang Medical College,Mudanjiang 157000,China;Department of Emergency,Red Flag Hospital Affiliated to Mudanjiang Medical College,Mudanjiang 157000,China;Department of Emergency,the Second Affiliated Hospital of Mudanjiang Medical College,Mudanjiang 157000,China)
出处
《西北药学杂志》
CAS
2022年第5期130-134,共5页
Northwest Pharmaceutical Journal
基金
黑龙江省卫生计生委科研课题(编号:2017-319)。
关键词
伊伐布雷定
左西孟旦注射液
慢性心衰
心功能
心肌纤维化
ivabradine
Levosimendan Injections
chronic heart failure
cardiac function
myocardial fibrosis
