卡托普利联合美托洛尔治疗老年慢性心力衰竭患者的临床疗效及其对血清心型脂肪酸结合蛋白和生长分化因子15水平的影响Clinical Effect of Captopril Combined with Metoprolol in Treating Elderly Patients with Chronic Cardiac Failure and Its Impact on Serum Levels of H-FABP and GDF-15
曾朝富;贾钦尧;蔺曜;牟博勇;黄晓玲;
摘要(Abstract):
目的观察卡托普利联合美托洛尔治疗老年慢性心力衰竭患者的临床疗效,并探讨其对血清心型脂肪酸结合蛋白(H-FABP)和生长分化因子15(GDF-15)水平的影响。方法选取2014年6月—2016年6月成都市温江区人民医院收治的老年慢性心力衰竭患者150例,采用随机数字表法分为对照组和观察组,每组75例。在常规治疗基础上,对照组患者给予卡托普利治疗,观察组患者在对照组基础上给予美托洛尔治疗;两组患者均连续治疗4周。比较两组患者临床疗效,治疗前后血压、心率及血清H-FABP、GDF-15水平,并观察两组患者治疗期间不良反应发生情况。结果观察组患者临床疗效优于对照组(P<0.001)。治疗前两组患者舒张压、收缩压、心率比较,差异无统计学意义(P>0.05);治疗后观察组患者舒张压、收缩压、心率低于对照组(P<0.05)。治疗前两组患者血清H-FABP、GDF-15水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清H-FABP、GDF-15水平低于对照组(P<0.05)。两组患者治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。结论卡托普利联合美托洛尔可有效提高老年慢性心力衰竭患者临床疗效,降低患者血压及血清H-FABP、GDF-15水平,减慢患者心率,且未增加不良反应发生风险。
关键词(KeyWords): 心力衰竭;老年人;卡托普利;美托洛尔;心型脂肪酸结合蛋白;生长分化因子15
基金项目(Foundation):
作者(Author): 曾朝富;贾钦尧;蔺曜;牟博勇;黄晓玲;
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参考文献(References):
- [1]EWEN S,MAHFOUD F,B?HM M.Chronic heart failure:current guideline recommendations and innovations[J].Internist(Berl),2015,56(7):791-802.DOI:10.1007/s00108-015-3703-2.
- [2]VOLPE M,CARNOVALI M,MASTROMARINO V.The natriuretic peptides system in the pathophysiology of heart failure:from molecular basis to treatment[J].Clin Sci(Lond),2016,130(2):57-77.DOI:10.1042/CS20150469.
- [3]GODA A,SUGAHARA M,DELGADO-MONTERO A,et al.Correlation of a new echocardiographic index of right ventricular remodeling in pulmonary hypertension with invasive hemodynamics in rat model[J].J Am Coll Cardiol,2016,67(13):2059.DOI:10.1016/s0735-1097(16)32060-5.
- [4]CHEN M,YU L,LIU Q,et al.Noninvasive vagus nerve stimulation:A novel promising modulator for cardiac autonomic nerve system dysfunction[J].Int J Cardiol,2015,187(1):338-339.DOI:10.1016/j.ijcard.2015.03.317.
- [5]卫娇娜,杨睿海,王永进,等.米力农对老年性顽固性心力衰竭患者心脏功能及N-末端脑钠肽前体水平的影响[J].海南医学院学报,2017,23(12):1613-1615,1619.DOI:10.13210/j.cnki.jhmu.20170627.003.
- [6]SWEDBERG K,CLELAND J,DARGIE H,et al.Guidelines for the diagnosis and treatment of chronic heart failure:executive summary(update 2005):The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology[J].Eur Heart J,2005,26(11):1115-1140.DOI:10.1093/eurheartj/ehi204.
- [7]ABRAHAM W T,SMITH S A.Devices in the management of advanced,chronic heart failure[J].Nat Rev Cardiol,2013,10(2):98-110.DOI:10.1038/nrcardio.2012.178.
- [8]H U B E R S S A,B R O W N N J.C o m b i n e d A n g i o t e n s i n Receptor Antagonism and Neprilysin Inhibition[J].Circulation,2016,133(11):1115-1124.DOI:10.1161/CIRCULATIONAHA.115.018622.
- [9]MUSTAFA H N,HEGAZY G A,AWDAN S A E,et al.Protective role of Co Q10 or L-carnitine on the integrity of the myocardium in doxorubicin induced toxicity[J].Tissue Cell,2017,49(3):410-426.DOI:10.1016/j.tice.2017.03.007.
- [10]黄丹娥,黄琳,曾巧煌,等.复方芪麻胶囊对自发性高血压大鼠血压及血清NO、ET、AngⅡ的影响[J].广东药学院学报,2015,31(6):791-794.DOI:10.3969/j.issn.1006-8783.2015.06.021.
- [11]张成,王建军.卡托普利与美托洛尔联合治疗老年慢性心力衰竭患者的远近期疗效[J].实用医学杂志,2016,32(19):3280-3281.DOI:10.3969/j.issn.1006-5725.2016.19.047.
- [12]梁大兴,饶惠清,聂振荣,等.充血性心力衰竭与多种神经内分泌因子的关相性研究[J].中国综合临床,2006,22(10):867-868.DOI:10.3760/cma.j.issn.1008-6315.2006.10.002.
- [13]BANK I E,DEKKER M S,HOES A W,et al.Suspected acute coronary syndrome in the emergency room:Limited added value of heart type fatty acid binding protein point of care or ELISA tests:The FAME-ER(Fatty Acid binding protein in Myocardial infarction Evaluation in the Emergency Room)study[J].Eur Heart J Acute Cardiovasc Care,2015,5(4):364-374.DOI:10.1177/2048872615584077.
- [14]PERNA E,MACIN S M,ALVARENGA P M,et al.High levels of T troponin in heart failure are associated with ventricular remodeling and unfavorable in-hospital course[J].Eur J Heart Fail,2015,2(S1):111.DOI:10.1016/S1388-9842(00)80398-0.
- [15]VOROVICH E,FRENCH B,HU R,et al.(465)-BAG3Variant Is Associated With Ventricular Remodeling But Not Clinical Outcomes in Chronic Heart Failure[J].J Heart Lung Transplant,2015,34(4):S176.DOI:10.1016/j.healun.2015.01.480.
- [16]刘宁,刘昊,王志军,等.丹参滴丸联合ARB对老年慢性心衰患者血清NT-pro BNP、H-FABP以及Nexilin含量影响研究[J].中华中医药学刊,2016,34(1):251-254.DOI:10.13193/j.issn.1673-7717.2016.01.071.
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