目的:观察曲美他嗪治疗对高血压合并2型糖尿病患者心功能及运动耐量的影响。方法:采用随机、双盲、安慰剂对照的前瞻性研究方法。选择高血压合并2型糖尿病患者60例,随机分成曲美他嗪治疗组和对照组各30例。两组均给予规范降压、降糖、...目的:观察曲美他嗪治疗对高血压合并2型糖尿病患者心功能及运动耐量的影响。方法:采用随机、双盲、安慰剂对照的前瞻性研究方法。选择高血压合并2型糖尿病患者60例,随机分成曲美他嗪治疗组和对照组各30例。两组均给予规范降压、降糖、抗血小板及他汀类药物降脂治疗,治疗组在此基础上口服盐酸曲美他嗪治疗,对照组使用安慰剂治疗,疗程为1年。两组治疗前后均行心脏超声心动图检查、运动心肺功能测定、血浆氨基端脑钠肽前体(NT-ProBNP)浓度测定,并测定其超敏C反应蛋白、TNF-α、血管紧张素Ⅱ、血浆内皮素等血浆细胞因子水平。结果:曲美他嗪治疗组治疗后,左心室质量指数、二尖瓣血流频谱E峰与A峰比值、二尖瓣环运动舒张早期峰速度与舒张晚期峰速度比值及收缩期峰值速度均明显改善,与治疗前及对照组治疗后差异均具有统计学意义(均 P <0.05);NT-ProBNP 下降,与治疗前及对照组治疗后差异均具有统计学意义(均 P <0.05);运动耐量改善,表现为运动时间延长,运动当量、最大摄氧量、无氧阈增大,各指标与治疗前及对照组治疗后差异均有统计学意义(均 P <0.05);治疗组超敏C反应蛋白、血浆内皮素、TNF-α、血管紧张素Ⅱ下降,相比治疗前及对照组治疗后差异均有统计学意义(均 P <0.05)。对照组未见上述指标在治疗前后有明显差异(均 P > 0.05)。两组均未发生严重不良反应。结论:曲美他嗪能有效改善高血压合并糖尿病患者的心功能,提高运动耐量。展开更多
Background Stress echocardiography is mainly used in detection of coronary artery disease （CAD） and to assess risk.This study aimed to use adenosine stress echocardiography （ASE） and N-terminal pro-B-type natriure...Background Stress echocardiography is mainly used in detection of coronary artery disease （CAD） and to assess risk.This study aimed to use adenosine stress echocardiography （ASE） and N-terminal pro-B-type natriuretic peptide （NT-proBNP） to noninvasively assess coronary stenosis in patients with chest pain syndromes or anginal equivalent.Methods NT-proBNP was measured after overnight fast in fifty patients, 42 males and 8 females, who were （57＋11）years old. They then underwent echocardiography before and during adenosine administration. Left ventricular （LV）diastolic function analyzed included mitral annular early （E＇） and late velocity （A＇） both at the mitral septal and lateral level and the mitral inflow to annulus ratio （E/E＇）. Coronary angiography was performed the following day after which patients were assigned to three groups： normal results （16 patients）, stenosis 50%-69%（17 patients） and stenosis≥70% （17 patients）.Results NT-proBNP levels in the groups of stenosis 50%-69% and≥ 70% were significantly higher than that in the group with normal results （P=0.014 and P=0.040）. During adenosine stress, the E/E＇ in the group of stenosis≥70% was higher than in the group of normal results （P=0.024）. E＇lateral/A＇lateral in the group of stenosis 50%-69% and E＇septal/A＇septal and E＇lateral/A＇lateral in the group of stenosis≥70% were also decreased during stress compared with baseline （P=0.003,P=0.001, P=0.022）. The variation of E＇septal/A＇septal before and during adenosine stress （△E＇septal/A＇septal） between the groups of normal results and stenosis ≥70% were significantly different （P=0.001）. By receiver operating characteristic （ROC）, the specificity of △E＇septal/A＇septal ≥0.037 predicting coronary stenosis ＜70% was 94%. The sensitivity and specificity of NT-proBNP≥544.6 fmol/ml in predicting coronary stenosis ≥70% were 93% and 75%, respectively.NT-proBNP inversely correlated with E＇lateral展开更多
文摘目的:观察曲美他嗪治疗对高血压合并2型糖尿病患者心功能及运动耐量的影响。方法:采用随机、双盲、安慰剂对照的前瞻性研究方法。选择高血压合并2型糖尿病患者60例,随机分成曲美他嗪治疗组和对照组各30例。两组均给予规范降压、降糖、抗血小板及他汀类药物降脂治疗,治疗组在此基础上口服盐酸曲美他嗪治疗,对照组使用安慰剂治疗,疗程为1年。两组治疗前后均行心脏超声心动图检查、运动心肺功能测定、血浆氨基端脑钠肽前体(NT-ProBNP)浓度测定,并测定其超敏C反应蛋白、TNF-α、血管紧张素Ⅱ、血浆内皮素等血浆细胞因子水平。结果:曲美他嗪治疗组治疗后,左心室质量指数、二尖瓣血流频谱E峰与A峰比值、二尖瓣环运动舒张早期峰速度与舒张晚期峰速度比值及收缩期峰值速度均明显改善,与治疗前及对照组治疗后差异均具有统计学意义(均 P <0.05);NT-ProBNP 下降,与治疗前及对照组治疗后差异均具有统计学意义(均 P <0.05);运动耐量改善,表现为运动时间延长,运动当量、最大摄氧量、无氧阈增大,各指标与治疗前及对照组治疗后差异均有统计学意义(均 P <0.05);治疗组超敏C反应蛋白、血浆内皮素、TNF-α、血管紧张素Ⅱ下降,相比治疗前及对照组治疗后差异均有统计学意义(均 P <0.05)。对照组未见上述指标在治疗前后有明显差异(均 P > 0.05)。两组均未发生严重不良反应。结论:曲美他嗪能有效改善高血压合并糖尿病患者的心功能,提高运动耐量。
文摘Background Stress echocardiography is mainly used in detection of coronary artery disease （CAD） and to assess risk.This study aimed to use adenosine stress echocardiography （ASE） and N-terminal pro-B-type natriuretic peptide （NT-proBNP） to noninvasively assess coronary stenosis in patients with chest pain syndromes or anginal equivalent.Methods NT-proBNP was measured after overnight fast in fifty patients, 42 males and 8 females, who were （57＋11）years old. They then underwent echocardiography before and during adenosine administration. Left ventricular （LV）diastolic function analyzed included mitral annular early （E＇） and late velocity （A＇） both at the mitral septal and lateral level and the mitral inflow to annulus ratio （E/E＇）. Coronary angiography was performed the following day after which patients were assigned to three groups： normal results （16 patients）, stenosis 50%-69%（17 patients） and stenosis≥70% （17 patients）.Results NT-proBNP levels in the groups of stenosis 50%-69% and≥ 70% were significantly higher than that in the group with normal results （P=0.014 and P=0.040）. During adenosine stress, the E/E＇ in the group of stenosis≥70% was higher than in the group of normal results （P=0.024）. E＇lateral/A＇lateral in the group of stenosis 50%-69% and E＇septal/A＇septal and E＇lateral/A＇lateral in the group of stenosis≥70% were also decreased during stress compared with baseline （P=0.003,P=0.001, P=0.022）. The variation of E＇septal/A＇septal before and during adenosine stress （△E＇septal/A＇septal） between the groups of normal results and stenosis ≥70% were significantly different （P=0.001）. By receiver operating characteristic （ROC）, the specificity of △E＇septal/A＇septal ≥0.037 predicting coronary stenosis ＜70% was 94%. The sensitivity and specificity of NT-proBNP≥544.6 fmol/ml in predicting coronary stenosis ≥70% were 93% and 75%, respectively.NT-proBNP inversely correlated with E＇lateral
