摘要
目的研究曲美他嗪联合美托洛尔对高血压合并糖尿病患者心肌重塑和炎症因子表达水平的影响。方法选取2021年1月至2022年6月金华广福肿瘤医院收治的高血压合并糖尿病患者96例,按照随机数字表法分为对照组(n=48)和研究组(n=48)。对照组患者给予常规降血糖及美托洛尔治疗,研究组患者在对照组基础上加用曲美他嗪治疗。比较治疗前后两组患者血压、血糖、心肌重塑指标、N末端B型利钠肽原(NT-ProBNP)、内皮素-1(ET-1)、一氧化氮(NO)及血管紧张素Ⅱ(AngⅡ)、炎症因子水平,并统计治疗期间不良反应发生情况。结果治疗后,研究组收缩压[(125.46±5.84)mm Hg(1 mm Hg≈0.133 kPa)],舒张压(78.74±5.33)mm Hg]均低于对照组[(134.06±6.74)mm Hg,(84.64±5.14)mm Hg](t=6.681,5.520,均P<0.05)。研究组血糖各项指标、心肌重塑各项指标均低于对照组(均P<0.05)。研究组NT-ProBNP[(120.21±14.08)pg·mL^(-1)]、ET-1[(1.47±0.12)ng·L^(-1)]及AngⅡ[(76.45±14.85)ng·L^(-1)]水平均低于对照组[(148.56±16.33)pg·mL^(-1),(2.24±0.36)ng·L^(-1),(86.51±15.22)ng·L^(-1)](t=9.109,14.058,3.278,均P<0.05),而研究组的NO水平则高于对照组[(58.54±5.71)μmol·L^(-1),(48.18±4.66)μmol·L^(-1);t=9.739,P<0.05)。研究组的炎症因子超敏C反应蛋白(hs-CRP)和肿瘤坏死因子-α(TNF-α)水平均低于对照组(均P<0.05)。两组不良反应发生率差异无统计学意义(χ^(2)=0.089,P=0.765)。结论曲美他嗪联合美托洛尔对高血压合并糖尿病患者的降压降糖效果较好,可有效改善心肌重塑及减轻炎症反应,安全系数高。
Objective To investigate the effect of trimetazidine combined with metoprolol on myocardial remodeling and inflammatory cytokine expression in patients with hypertension and diabetes mellitus.Methods A total of 96 patients with hypertension and diabetes mellitus admitted to Guangfu Cancer Hospital from January 2021 to June 2022 were selected as subjects and divided into the control group(n=48)and study group(n=48)according to the random number table method.The patients in the control group were treated with conventional hypoglycemic and metoprolol and those in the study group with trimetazidine on the basis of treatment regimen in the control group.Blood pressure,blood glucose,myocardial remodeling indexes,N-terminal pro-B-type natriuretic peptide(NT-ProBNP),endothelin-1(ET-1),nitric oxide(NO),angiotensinⅡ(AngⅡ)levels and inflammatory cytokine levels were detected and compared between the two groups before and after treatment.The incidence of adverse reactions during treatment was counted.Results After treatment,systolic blood pressure and diastolic blood pressure in the study group were lower than those in the control group((125.46±5.84)mm Hg(1 mm Hg≈0.133 kPa)vs(134.06±6.74)mm Hg,(78.74±5.33)mm Hg vs(84.64±5.14)mm Hg,t=6.681,5.520,both P<0.05).The indexes of blood glucose and myocardial remodeling of patients in the study group were lower than those in the control group(all P<0.05).NT-ProBNP((120.21±14.08)pg·mL^(-1)),ET-1((1.47±0.12)ng·L^(-1))and AngⅡ((76.45±14.85)ng·L^(-1) in the study group were lower than those in the control group((148.56±16.33)pg·mL^(-1),(2.24±0.36)ng·L^(-1),(86.51±15.22)ng·L^(-1),t=9.109,14.058,3.278,all P<0.05).However,the NO in the study group was higher than that in the control group((58.54±5.71)μmol·L^(-1) vs(48.18±4.66)μmol·L^(-1),t=9.739,P<0.05).The levels of hs-CRP and TNF-αin the study group were lower than those in the control group(t=2.482,4.321,both P<0.05).There was no significant difference in the incidence of adverse reactions between the two g
作者
何锦平
蔡少澜
郑亚琪
郑美暄
He Jin-ping;Cai Shao-lan;Zheng Ya-qi;Zheng Mei-xuan(Department of Cardiovascular Disease Treatment,Guangfu Cancer Hospital,Jinhua 321000,China;Department of Cardiology,Guangfu Cancer Hospital,Jinhua 321000,China;Department of Geriatrics,Guangfu Cancer Hospital,Jinhua 321000,China)
出处
《中国药物应用与监测》
CAS
2024年第5期536-539,共4页
Chinese Journal of Drug Application and Monitoring
基金
2014年金华市科学技术局社会发展类重点项目(2014A32129)。
关键词
高血压
糖尿病
曲美他嗪
美托洛尔
心肌重塑
炎症因子
Hypertension
Diabetes mellitus
Trimetazidine
Metoprolol
Cardiac remodeling
Inflammatory cytokine
