螺内酯对慢性心力衰竭患者左心室功能及血清趋化素的影响  

Effect of spironolactone on left ventricular function and serum chemerin in patients with chronic heart failure

作　　者：王亚玲[1] 张杨[1] 刘涛[1] 郭安君 王梅[1] WANG Ya-ling;ZHANG Yang;LIU Tao;GUO An-jun;WANG Mei(Department of Cardiovascular Medicine, the Second Hospital of Hebei Medical University, Shijiazhuang 050000, China)

机构地区：[1]河北医科大学第二医院心内科,河北石家庄050000

出　　处：《河北医科大学学报》2020年第7期749-753,共5页Journal of Hebei Medical University

摘　　要：目的探讨螺内酯对慢性心力衰竭患者左心室功能及血清趋化素的影响。方法选取慢性心力衰竭患者80例,随机分为对照组和研究组,对照组采用常规治疗,研究组在对照组基础上采用螺内酯治疗。比较2组治疗前后炎症因子水平[高敏C反应蛋白(hypersensitive C-reactive protein,hs-CRP)、白细胞介素6(interleukin-6,IL-6)、肿瘤坏死因子α(tumor necrosis factor-α,TNF-α)]、血脂水平[低密度脂蛋白胆固醇(low density lipoprotein cholesterol,LDL-C)、总胆固醇(total cholesterol,TC)、三酰甘油(triglyceride,TG)]、心功能[左心室收缩末期容积(left ventricular end systolic volume,LVESV)、左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期容积(left ventricular end diastolic volume,LVEDV)]、6 min步行距离、血清血管内皮生长因子(vascular endothelial growth factor,VEGF)、趋化素、脑钠肽(brain natriuretic peptide,BNP)水平、应激反应。结果治疗后,2组hs-CRP、IL-6、TNF-α、LDL-C、TC、TG、LVESV、LVEDV、VEGF、趋化素、BNP、MDA水平均明显低于治疗前,LVEF、AOA、GPx均高于治疗前,6 min步行距离长于治疗前,研究组hs-CRP、IL-6、TNF-α、LDL-C、TC、TG、LVESV、LVEDV、VEGF、趋化素、BNP、MDA水平均低于对照组,LVESV、LVEF、LVEDV、AOA、GPx均高于对照组,6 min步行距离长对照组,差异有统计学意义(P<0.05或P<0.01)。结论螺内酯治疗慢性心力衰竭患者,效果理想,可降低炎症因子、血脂水平及应激反应,改善患者心功能,提高6 min步行距离,改善血清VEGF、趋化素、BNP水平,值得在临床上大力推广。Objective To investigate the effect of spironolactone on left ventricular function and serum chemoin in patients with chronic heart failure.Methods Eighty patients with chronic heart failure were randomly divided into a control group and a research group.The control group received conventional treatment,and the research group received spironolactone treatment based on the control group.Compare the levels of inflammatory factors before and after treatment in the two groups[hypersensitive C-reactive protein(hs-CRP),interleukin 6(Interleukin-6,IL-6),tumor necrosis factor-α(tumor necrosis factor-α,TNF-α)],blood lipid levels[low density lipoprotein cholesterol(LDL-C),total cholesterol(TC),triglyceride(TG)],cardiac function[left ventricular end systole Left ventricular end systolic volume(LVESV),left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV)],6 min walking distance,serum vascular endothelial growth factor(VEGF),chemerin,Brain natriuretic peptide(BNP)level and stress response.Results After treatment,the levels of hs-CRP,IL-6,TNF-α,LDL-C,TC,TG,LVESV,LVEDV,VEGF,chemerin,BNP,and MDA were significantly lower than before treatment,and LVEF,AOA,GPx were high Before treatment,the 6-minute walking distance was longer than before treatment.The levels of hs-CRP,IL-6,TNF-α,LDL-C,TC,TG,LVESV,LVEDV,VEGF,chemerin,BNP,and MDA were lower in the study group than in the control group.,LVESV,LVEF,LVEDV,AOA,and GPx were higher than the control group,and the control group with a 6-minute walking distance was significantly different(P<0.05 or P<0.01).Conclusion Spironolactone is effective in the treatment of patients with chronic heart failure.It can reduce inflammatory factors,blood lipid levels and stress responses,improve patients cardiac function,increase 6-minute walking distance,and improve serum VEGF,Chemerin,and BNP levels.It is worthy of clinical promotion.

关 键 词：心力衰竭 螺内酯 趋化因子类 

分 类 号：R541.6[医药卫生—心血管疾病]