摘要
目的探究辛伐他汀联合抗阻训练对慢性心力衰竭(CHF)患者心功能及外周血单个核细胞(PBMCs)内沉默信息调节因子2相关酶3(Sirt3)、核转录因子-κB(NF-κB)信号通路的影响,为CHF的治疗提供依据。方法选择2014年2月至2017年9月上海中山医院青浦分院收治的116例CHF患者作为研究对象,用随机数字表法分为联合治疗组和对照组,每组58例。两组均采取常规抗心衰治疗,于此基础上对照组采取抗阻训练治疗,联合治疗组采取辛伐他汀联合抗阻训练治疗,两组患者均治疗3个月。治疗3个月后比较两组患者临床效果与治疗前、治疗3个月后心功能指标[舒张期室间隔厚度(IVST)、左室舒张末内径(LVDD)、左心室射血分数(LVEF)]、血清炎症反应指标[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]及PBMCs内Sirt3、NF-κB的相对m RNA水平,治疗后随访6个月,比较两组患者治疗后3个月、6个月时不良心脏事件(MACE)发生率。用SPSS 20.0统计软件对数据进行t检验和χ~2检验。结果治疗3个月后,联合治疗组总有效率(91.38%)明显高于对照组(70.69%),差异有统计学意义(P<0.05)。治疗前两组患者心功能指标、炎症指标比较,差异均无统计学意义(P>0.05),治疗3个月后,两组患者IVST、LVDD、血清CRP、TNF-α、IL-6水平均较治疗前明显降低,且联合治疗组较对照组降低更明显,LVEF水平较治疗前明显升高,且联合治疗组较对照组升高更明显,差异均有统计学意义(P<0.05)。治疗前两组患者PBMCs内Sirt3、NF-κB的相对m RNA水平比较,差异均无统计学意义(P>0.05),治疗3个月后,两组患者PBMCs内Sirt3、NF-κB的相对m RNA水平均较治疗前明显降低,且联合治疗组较对照组降低更明显,差异均有统计学意义(P<0.05)。联合治疗组治疗后3个月、6个月时MACE发生率(分别为3.45%、5.17%)明显低于对照组(分别为15.52%、18.97%),差异有统计学意义(P<0.05)。结论 CHF
Objective To investigate the effects of simvastatin combined with anti-resistance training on cardiac function,Sirt3 and NF-κB signaling pathways of peripheral blood mononuclear cells(PBMCs) in patients with chronic heart failure(CHF),and to provide the basis for treatment of CHF.Methods From February of 2014 to September of 2017,116 inpatients with CHF in Shanghai Zhongshan Hospital served as the subjects.The subjects were divided into the experimental group(n =58) and the control group(n=58) by random number table method.Both groups were treated with conventional anti-heart failure.On the basis of this treatment,the control group was treated with anti-resistance training for 3 months;the experimental group was treated with simvastatin combined with anti-resistance training for 3 months.After 3 months of treatment,the clinical effects of the two groups were compared;and the cardiac function indicators [diastolic interventricular septum thickness(IVST),left ventricular end diastolic diameter(LVDD),left ventricular ejection fraction(LVEF)] before the treatment and after 3 months of treatment were compared;also serum inflammatory response indicators [C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)] and relative mRNA levels of Sirt3,NF-κB in PBMCs before the treatment and after 3 months of treatment were compared.After following up for 6 months,the incidences of adverse cardiac events(MACE) between the two groups in 3 treatment months and in following up for 6 months were compared.Results After 3 months of treatment,the total effective rate of the experimental group(91.38%) was significantly higher than that(70.69%) of the control group(P<0.05).Before treatment,there were no significant differences of IVST,LVDD and LVEF between the two groups(P>0.05).The levels of IVST or LVDD and the levels of serum CRP,TNF-α and IL-6 after treatment for 3 months were significantly lower than those before the treatment in the two groups,also those indicators in experimental group were significantly l
作者
王韦
张政
WANG Wei;ZHANG Zheng(Qingpu Branch of Shanghai Zhongshan Hospital,Shanghai 201700,China)
出处
《中国慢性病预防与控制》
CAS
CSCD
北大核心
2019年第2期97-101,共5页
Chinese Journal of Prevention and Control of Chronic Diseases
