西拉普利联合单硝酸异山梨酯治疗COPD合并心衰疗效及对患者血清心肺功能指标和炎症因子的影响  

The Curative Effect of Cilazapril Combined with Isosorbide Mononitrate on COPD and Heart Failure and The Influences on Serum Cardiopulmonary Function Indexes and Inflammatory Factors

作　　者：林丹丹 周燕 杨明福 LIN Dandan;ZHOU Yan(The First Affiliated Hospital of Army Military Medical University,Chongqing 400038,China)

机构地区：[1]陆军军医大学第一附属医院,重庆400038 [2]空军第986医院急诊科,陕西西安710000

出　　处：《河北医学》2020年第7期1088-1091,共4页Hebei Medicine

基　　金：重庆市科技计划项目,(编号:201501427)。

摘　　要：目的:探究西拉普利联合单硝酸异山梨酯治疗慢性阻塞性肺病(COPD)合并心衰的临床疗效及对患者血清心肺功能和炎症因子的影响.方法:选取2017年5月至2018年3月本院收治的COPD合并心衰患者150例,采用简单随机分组法将患者分为观察组(n=75)和对照组(n=75).对照组给予单硝酸异山梨酯治疗,观察组在此基础上加服西拉普利,比较两组患者的临床疗效、心肺功能和炎症因子等指标.结果:观察组的临床疗效总有效率为90.67%高于对照组的78.67%(P<0.05);治疗前,两组患者的各项心功能、肺功能和炎症因子指标指标比较无统计学差异(P>0.05);治疗后,观察组的LVEF水平、FVC、FEV1和FEV1/FVC水平均高于对照组(P<0.05);LVEDD、BNP和hs-CRP水平、血清IL-6、IL-8和TNF-α 水平均低于对照组(P<0.05).结论:西拉普利联合单硝酸异山梨酯在治疗COPD合并心衰方面疗效确切,能提高治疗有效率,改善患者临床症状及心肺功能,抑制炎症因子表达,降低炎性反应,值得临床上推广与应用.Objective:To explore clinical curative effect of cilazapril combined with isosorbide mononitrate on COPD and heart failure and their influences on serum cardiopulmonary function and inflammatory factors.Methods:A total of 150 patients with COPD and heart failure who were admitted to the hospital from May 2017 to March 2018 were enrolled.They were divided into observation group(n=75)and control group(n=75)by simple random grouping method.The control group was treated with isosorbide mononitrate,while observation group was additionally treated with cilazapril.The clinical curative effect,cardiopulmonary function and inflammatory factors indexes were compared between the two groups.Result:The total response rate of clinical curative effect in observation group was higher than that in control group(90.67%vs 78.67%)(P<0.05).Before treatment,there were no statistical differences in cardiac function,pulmonary function and inflammatory factors indexes between the two groups(P>0.05).After treatment,levels of LVEF,FVC,FEV1 and FEV1/FVC in observation group were higher than those in control group(P<0.05),while levels of LVEDD,BNP,hs-CRP,serum IL-6,IL-8 and TNF-αwere lower than those in control group(P<0.05).Conclusion:The curative effect of cilazapril combined with isosorbide mononitrate is significant on COPD combined with heart failure.It can improve response rate of treatment,clinical symptoms and cardiopulmonary function,down-regulate expression of inflammatory factors,and reduce inflammatory response.

关 键 词：心衰 慢性阻塞性肺病 西拉普利 单硝酸异山梨酯 

分 类 号：R563.9[医药卫生—呼吸系统] R541.6[医药卫生—内科学]