β受体阻滞剂治疗高血压性心脏病患者效果及对血清FGF-21、NF-proBNP和QTd的影响  

Effect of β-blockers in patients with hypertensive heart disease and the fibroblast growth factor 21,N-terminal probrain natriuretic peptide and QT interval dispersion influences

作　　者：阳慧[1] 苏雨江[1] 钟江华[1] 马添翼[1] YANG Hui;SU Yujiang;ZHONG Jianghua;MA Tianyi(Department of Cardiology, Haikou Hospital, Xiangya School of Medicine, Central South University, Haikou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院/海口市人民医院心血管内科,570208

出　　处：《疑难病杂志》2019年第1期19-22,26,共5页Chinese Journal of Difficult and Complicated Cases

摘　　要：目的观察β受体阻滞剂治疗高血压性心脏病的疗效及对血清成纤维细胞生长因子21 (FGF-21)、N末端脑钠肽前体(NT-proBNP)及QT间期离散度(QTd)的影响。方法选择2016年8月—2017年7月中南大学湘雅医学院附属海口医院心血管内科收治高血压性心脏病患者200例为研究对象。随机数字表法分为对照组和观察组,各100例。对照组采用地高辛片+螺内酯片+依那普利片治疗,观察组在对照组用药的基础上给予酒石酸美托洛尔片治疗。比较2组患者治疗前后临床疗效、心功能及FGF-21、NT-proBNP、QTd变化。结果观察组总有效率明显高于对照组(92.00%vs. 79.00%,χ~2/P=6.816/0.009)。治疗后,2组LVEF、CO水平均升高,LVESD、LVESV、FGF-21、NT-proBNP、QTd水(t/P_(对照组)=8. 893/0. 000、8. 566/0. 000、6. 631/0. 000、6. 903/0. 000、7. 292/0. 000、9. 393/0. 000、2. 318/0.021; t/P_(观察组)=18. 272/0. 000、14. 074/0. 000、14. 711/0. 000、16. 910/0. 000、13. 087/0. 000、15. 597/0. 000、6. 849/0.000),观察组变化幅度大于对照组(t/P=9. 645/0. 000、4. 430/0. 000、7. 972/0. 000、11. 599/0. 000、5. 760/0.000、12.974/0.000、5. 304/0.000);2组治疗期间均未出现明显不良反应(χ~2/P=0. 000/1.000)。结论β受体阻滞剂可显著改善高血压性心脏病患者心功能,降低FGF-21、NT-proBNP、QTd水平,临床疗效确切,且无明显不良反应,临床可应用推广。Objective To observe the efficacy of β-blockers in the treatment of hypertensive heart disease and the effect of serum fibroblast growth factor 21 (FGF-21), N-terminal pro-brain natriuretic peptide (NT-proBNP) and QT interval dispersion (QTd) influences. Methods From August 2016 to July 2017, 200 patients with hypertensive heart disease were enrolled in the Department of Cardiology, Haikou Hospital affiliated to Xiangya School of Medicine, Central South University. The random number table method was divided into control group and observation group, 100 cases each. The control group was treated with digoxin tablets + spironolactone tablets + enalapril tablets, and the observation group was treated with metoprolol tartrate tablets on the basis of the control group. The clinical efficacy, cardiac function and changes of FGF-21, NT-ProBNP and QTd were compared before and after treatment. Results The total effective rate of the observation group was significantly higher than that of the control group (92.00% vs. 79.00%,χ^2/ P =6.816/0.009). After treatment, the LVEF and CO levels in the two groups increased, and the LVESD, LVESV, FGF-21, NT-proBNP, and QTd levels decreased (control group: t/P =8.893/0.000, t/P =8.566/0.000, t/P =6.631/0.000, t/P =6.903/0.000, t/P =7.292/0.000, t/P =9.393/ 0.000 , t/P =2.318/0.021; observation group: t/P =18.272/0.000, t/ P =14.074/0.000, t/P =14.711/0.000, t/P =16.910/0.000, t/P =13.087/0.000, t/P =15.597/0.000, t/P =6.849/0.000), observation group change The amplitude is greater than the control group ( t/P =9.645/0.000, t/P =4.430/0.000, t/P =7.972/0.000, t/P =11.599/0.000, t/P =5.760 /0.000, t/P =12.974 /0.000, t/P = 5.304/0.000); no significant adverse reactions occurred during the two treatment periods (χ^2/ P =0.000/1.000). Conclusion Β-blockers can significantly improve cardiac function in patients with hypertensive heart disease, reduce the levels of FGF-21, NT-proBNP, QTd, clinical efficacy, and no significant adverse reactions, can be clinically applied.

关 键 词：Β受体阻滞剂 高血压性心脏病 血清成纤维细胞生长因子21 N末端脑钠肽前体 QT间期离散度 

分 类 号：R541.3[医药卫生—心血管疾病]