Major advances have been made over the last decade in our understanding of the molecular basis ofseveral cardiac conditions. Hypertrophic cardiomyopathy (HCM) was the first cardiac disorder in whicha genetic basis was...Major advances have been made over the last decade in our understanding of the molecular basis ofseveral cardiac conditions. Hypertrophic cardiomyopathy (HCM) was the first cardiac disorder in whicha genetic basis was identified and as such, has acted as a paradigm for the study of an inherited cardiacdisorder. HCM can result in clinical symptoms ranging from no symptoms to severe heart failure andpremature sudden death. HCM is the commonest cause of sudden death in those aged less than 35 years,including competitive athletes. At least ten genes have now been identified, defects in which cause HCM.All of these genes encode proteins which comprise the basic contractile unit of the heart, i.e. the sarcomere.While much is now known about which genes cause disease and the various clinical presentations, very littleis known about how these gene defects cause disease, and what factors modify the expression of the mutantgenes. Studies in both cell culture and animal models of HCM are now beginning to shed light on thesignalling pathways involved in HCM, and the role of both environmental and genetic modifying factors.Understanding these mechanisms will ultimately improve our knowledge of the basic biology of heart musclefunction, and will therefore provide new avenues for treating cardiovascular disease in man.展开更多
目的:探讨益心舒胶囊联合富马酸比索洛尔(Bisoprolol fumarate,BIS)的中西药联合药物方案治疗肥厚型心肌病、有临床症状/体征患者的临床价值。方法:选取2013年1月至2017年12月北京潞河医院收治的确诊为肥厚型心肌病、有临床症状/体征(...目的:探讨益心舒胶囊联合富马酸比索洛尔(Bisoprolol fumarate,BIS)的中西药联合药物方案治疗肥厚型心肌病、有临床症状/体征患者的临床价值。方法:选取2013年1月至2017年12月北京潞河医院收治的确诊为肥厚型心肌病、有临床症状/体征(中医辨证为气血痹阻型)患者160例作为研究对象,按就诊顺序随机分为对照组和观察组,每组80例。对照组应用BIS治疗,观察组应用BIS+益心舒胶囊治疗。疗程均为1个月。观察2组患者治疗前后心功能指标(左室舒张末期压、左室流出道压力阶差)、NYHA心功能分级、自觉症状、生命质量的改善情况,以及临床总疗效。结果:1)2组总有效率分别是96.43%和78.57%,2组比较差异有统计学意义(χ 2=3.840, P =0.045)。2)治疗后2组左室舒张末期压、左室流出道压力阶差及心功能分级均较其治疗前明显改善( P <0.05)。观察组左室舒张末期压( t =9.048, P =0.000)、左室流出道压力阶差( t =3.345, P =0.001)、心功能分级( t =4.637, P =0.000)的改善均较对照组明显。3)治疗后2组患者的自觉症状、生命质量均较治疗前明显改善(均 P <0.05)。2组间治疗后自觉症状( t =24.199, P =0.000)、生命质量评分( t = 8.627, P =0.000)比较,差异均有统计学意义(均 P <0.05)。4)治疗用药期间2组均未出现与药物相关的不良反应。观察组异常心率减慢出现2例(2.25%,2/80),对照组出现9例(10.11%,9/80),2组不良反应发生率的比较,差异有统计学意义(χ 2=7.320, P =0.007)。结论:益心舒胶囊联合BIS的中西药联合药物方案治疗肥厚型心肌病患者可以获得更为理想的临床效果,患者的自觉症状和生命质量的改善更为显著,且心功能指标的改善更佳。展开更多
文摘Major advances have been made over the last decade in our understanding of the molecular basis ofseveral cardiac conditions. Hypertrophic cardiomyopathy (HCM) was the first cardiac disorder in whicha genetic basis was identified and as such, has acted as a paradigm for the study of an inherited cardiacdisorder. HCM can result in clinical symptoms ranging from no symptoms to severe heart failure andpremature sudden death. HCM is the commonest cause of sudden death in those aged less than 35 years,including competitive athletes. At least ten genes have now been identified, defects in which cause HCM.All of these genes encode proteins which comprise the basic contractile unit of the heart, i.e. the sarcomere.While much is now known about which genes cause disease and the various clinical presentations, very littleis known about how these gene defects cause disease, and what factors modify the expression of the mutantgenes. Studies in both cell culture and animal models of HCM are now beginning to shed light on thesignalling pathways involved in HCM, and the role of both environmental and genetic modifying factors.Understanding these mechanisms will ultimately improve our knowledge of the basic biology of heart musclefunction, and will therefore provide new avenues for treating cardiovascular disease in man.
文摘目的:探讨益心舒胶囊联合富马酸比索洛尔(Bisoprolol fumarate,BIS)的中西药联合药物方案治疗肥厚型心肌病、有临床症状/体征患者的临床价值。方法:选取2013年1月至2017年12月北京潞河医院收治的确诊为肥厚型心肌病、有临床症状/体征(中医辨证为气血痹阻型)患者160例作为研究对象,按就诊顺序随机分为对照组和观察组,每组80例。对照组应用BIS治疗,观察组应用BIS+益心舒胶囊治疗。疗程均为1个月。观察2组患者治疗前后心功能指标(左室舒张末期压、左室流出道压力阶差)、NYHA心功能分级、自觉症状、生命质量的改善情况,以及临床总疗效。结果:1)2组总有效率分别是96.43%和78.57%,2组比较差异有统计学意义(χ 2=3.840, P =0.045)。2)治疗后2组左室舒张末期压、左室流出道压力阶差及心功能分级均较其治疗前明显改善( P <0.05)。观察组左室舒张末期压( t =9.048, P =0.000)、左室流出道压力阶差( t =3.345, P =0.001)、心功能分级( t =4.637, P =0.000)的改善均较对照组明显。3)治疗后2组患者的自觉症状、生命质量均较治疗前明显改善(均 P <0.05)。2组间治疗后自觉症状( t =24.199, P =0.000)、生命质量评分( t = 8.627, P =0.000)比较,差异均有统计学意义(均 P <0.05)。4)治疗用药期间2组均未出现与药物相关的不良反应。观察组异常心率减慢出现2例(2.25%,2/80),对照组出现9例(10.11%,9/80),2组不良反应发生率的比较,差异有统计学意义(χ 2=7.320, P =0.007)。结论:益心舒胶囊联合BIS的中西药联合药物方案治疗肥厚型心肌病患者可以获得更为理想的临床效果,患者的自觉症状和生命质量的改善更为显著,且心功能指标的改善更佳。
