曲美他嗪联合比索洛尔对慢性心力衰竭患者心功能、心室重构及神经内分泌因子的影响  

Effect of trimetazidine combined with bisoprolol on the cardiac function,ventricular remodeling and neuroendocrine factors in patients with chronic heart failure

作　　者：赵志华 

机构地区：[1]宝鸡市凤县医院内二科,陕西宝鸡721700

出　　处：《海南医学院学报》2017年第9期1183-1186,1190,共5页Journal of Hainan Medical University

基　　金：陕西省卫生厅卫生科研基金项目(2010H24)~~

摘　　要：目的:探讨曲美他嗪联合比索洛尔对慢性心力衰竭患者心功能、心室重构及神经内分泌因子的影响。方法:收集2012年1月~2015年11月间本院收治的慢性心力衰竭患者52例,按照双盲随机对照法将入组患者分为接受比索洛尔治疗的对照组、接受曲美他嗪联合比索洛尔治疗的观察组,各26例,均持续治疗3个月。治疗前、治疗3个月后,采用心脏彩色多普勒超声诊断仪测定两组心功能参数、心室重构参数水平,采用放射免疫法测定外周血神经内分泌因子含量。结果:治疗前,两组心功能、心室重构、神经内分泌因子水平差异无统计学意义(P>0.05)。治疗3个月后,观察组心功能参数左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESD)水平低于对照组,左室射血分数(LVEF)水平高于对照组,心室重构参数左心室后壁厚度(LVPWT)、室间隔收缩末期厚度(IVSS)、左心室后壁舒张末期厚度(PWD)、左心室后壁收缩末期厚度(PWS)、左室心肌质量指数(LVMI)水平低于对照组(P<0.05);观察组外周血神经内分泌因子去甲肾上腺素(NE)、醛固酮(ALD)、血管紧张素Ⅱ(AngⅡ)、心钠素(ANP)、内皮素(ET)含量低于对照组(P<0.05)。结论:曲美他嗪联合比索洛尔可优化慢性心力衰竭患者的心功能并抑制心室重构进程,调节机体神经内分泌因子分泌,有助于患者整体病情优化。Objective：To study the effect of trimetazidine combined with bisoprolol on the cardiac function,ventricular remodeling and neuroendocrine factors in patients with chronic heart failure.Methods：52patients with chronic heart failure who were treated in our hospital between January 2012 and November 2015 were collected and divided into the control group（n=26）who received bisoprolol therapy and the observation group（n=26）who received trimetazidine combined with bisoprolol therapy according to the double-blind randomized control method,and both groups were treated for 3months.Before treatment and after 3months of treatment,cardiac color Doppler diasonograph was used to determine the levels of cardiac function parameters and ventricular remodeling parameters,and RIA method was used to determine the levels if peripheral blood neuroendocrine factors.Results：Before treatment,the differences in cardiac function,ventricular remodeling and neuroendocrine factor levels were not statistically significant between two groups of patients（P〈0.05）.After 3months of treatment,cardiac function parameters LVEDd and LVESD levels of observation group were lower than those of control group while LVEF level was higher than that of control group,and ventricular remodeling parameters LVPWT,IVSS,PWD,PWS and LVMI levels were lower than those of control group（P〈0.05）;peripheral blood neuroendocrine factors NE,ALD,AngⅡ,ANP and ET contents of observation group were lower than those of control group（P〈0.05）.Conclusion：Trimetazidine combined with bisoprolol can optimize the cardiac function,suppress the ventricular remodeling process and regulate the neuroendocrine factor secretion in patients with chronic heart failure,and it contributes to the patients＇ overall optimization.

关 键 词：慢性心力衰竭 曲美他嗪 比索洛尔 心功能 心室重构 神经内分泌因子 

分 类 号：R541.6[医药卫生—心血管疾病]