不同剂量环磷腺苷葡甲胺治疗老年CHF的疗效及其对血清NT-proBNP、Hcy、CRP水平的影响  

Therapeutic effect of different doses of meglumine adenosine cyclophosphate on aged CHF patients and its influence on serum levels of NT-proBNP,Hcy and CRP

作　　者：王明建 WANG Ming-jian(Department of Cardiology,Motou Hospital of Rugao City,Rugao,Jiangsu,226500,China)

机构地区：[1]江苏省南通市如皋磨头医院内科,江苏南通226500

出　　处：《心血管康复医学杂志》2020年第4期467-470,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:研究不同剂量环磷腺苷葡甲胺(MACP)治疗老年慢性心力衰竭(CHF)的疗效及其对血清N基末端前脑利钠肽(NT-proBNP)、同型半胱氨酸(Hcy)、CRP水平的影响.方法:2015年6月~2017年4月我院老年CHF患者308例被随机均分为MACP:低剂量组(90mg/d)和高剂量组(120mg/d),两组均接受常规治疗,疗程2周.观察比较两组治疗前后症状改善情况、6min步行距离(6MWD)、QT离散度(QTd)、心率、血清NT-proBNP、Hcy、CRP水平及治疗总有效率和不良反应发生率.结果:高剂量组治疗总有效率显著高于低剂量组(90.91%比83.12%,P=0.042).与低剂量组比较,高剂量组治疗后胸闷伴活动后气促比例(16.88%比9.09%)、QTd[(36.73±6.01)ms比(27.31±5.41)ms]、心率[(82.18±6.82)次/min比(73.66±6.54)次/min]、血清NT-proBNP[(1104.55±263.50)pg/ml比(1005.19±202.20)pg/ml]、Hcy[(8.57±2.29)μmol/L比(6.76±2.05)μmol/L]、CRP[(7.21±2.99)mg/L比(5.30±2.16)mg/L]水平降低更显著,6MWD[(350.00±48.00)m比(385.00±53.00)m]升高更显著(P<0.05或<0.01).结论:高剂量环磷腺苷葡甲胺治疗老年CHF患者疗效更加显著,能显著改善患者心功能、降低血清NT-proBNP、Hcy、CRP水平.Objective:To study therapeutic effect of different doses of meglumine adenosine cyclophosphate(MACP) on aged patients with chronic heart failure(CHF) and its influence on serum levels of N-terminal pro-brain natriuretic peptide(NT-proBNP), homocysteine(Hcy) and CRP. Methods:A total of 308 aged CHF patients in our hospital from Jun 2015 to Apr 2017 were randomly and equally divided into MACP low dose group(90 mg/d) and MACP high dose group(120 mg/d), both groups received routine treatment all for two weeks. Improvement of symptoms, 6 min walking distance(6 MWD), QT dispersion(QTd), HR,serum levels of NT-proBNP, Hcy and CRP before and after treatment, total effective rate and incidence rate of adverse reactions were observed and compared between two groups. Results:Total effective rate of high dose group was significantly higher than that of low dose group(90.91% vs. 83.12%, P=0.042). Compared with low dose group, after treatment, there were significant reductions in percentage of chest tightness complicated shortness of breath after exercise(16.88% vs. 9.09%), QTd [(36.73±6.01)ms vs.(27.31±5.41)ms], HR [(82.18±6.82) beats/min vs.(73.66±6.54) beats/min],serum levels of NT-proBNP [(1104.55±263.50)pg/ml vs.(1005.19±202.20)pg/ml], Hcy [(8.57±2.29)μmol/L vs.(6.76±2.05) μmol/L] and CRP [(7.21±2.99)mg/L vs.(5.30±2.16) mg/L], and significant rise in 6 MWD [(350.00±48.00)m vs.(385.00±53.00)m] in high dose group(P<0.05 or <0.01).Conclusion:High dose meglumine adenosine cyclophosphate possesses more significant therapeutic effect on aged CHD patients. It can significantly improve cardiac function and reduce serum levels of NT-proBNP, Hcy and CRP.

关 键 词：心力衰竭 老年人 剂量效应关系 药物 

分 类 号：R541.62[医药卫生—心血管疾病]