托伐普坦联合氢氯噻嗪治疗慢性心力衰竭的疗效及对血清Hcy、NTpro-BNP水平的影响  

Efficacy of Topvastatin Combined with Hydrochlorothiazide on Chronic Heart Failure and Its Effect on the Serum Hcy and NTpro-BNP Levels

作　　者：张怀金[1] 王士强[1] 赵立[1] 王攀 马阳 王晓晨[2] ZHANG Huai-jin;WANG Shi-qiang;ZHAO Li;WANG Pan;MA Yang;WANG Xiao-chen(Department of Cardiology,Huaibei People's Hospital,Huaibei,Anhui,235000,China;Department of Cardiology,Second Affiliated Hospital of Anhui Medical University,Hefei,Anhui,230601,China)

机构地区：[1]淮北市人民医院心血管内科,安徽淮北235000 [2]安徽医科大学第二附属医院心血管内科,安徽合肥230601

出　　处：《现代生物医学进展》2020年第14期2750-2753,共4页Progress in Modern Biomedicine

基　　金：安徽省教育厅重点项目(2018A0236)。

摘　　要：目的:探讨托伐普坦联合氢氯噻嗪治疗慢性心力衰竭的疗效及对患者血清同型半胱氨酸(Hcy)、N末端脑钠肽前体(NTpro-BNP)水平的影响。方法:选择2018年1月-2019年12月在我院接受治疗的94例慢性心力衰竭患者,采用抽签法分为观察组(n=47)和对照组(n=47)。对照组给予氢氯噻嗪治疗,观察组在对照组的基础上给予托伐普坦治疗。比较两组患者的临床疗效、治疗前后血清Hcy、NTpro-BNP、左室收缩末期内径(LVESD)、左心室射血分数(LVEF)、6min步行距离、层黏连蛋白(LN)、透明质酸(HA)水平的变化情况及不良反应发生情况。结果:治疗后,两组总有效率分别为93.62%,74.47%,观察组显著高于对照组(P<0.05);治疗前,两组血清Hcy、NTpro-BNP水平比较无明显差异;治疗后,两组血清Hcy、NTpro-BNP水平均较治疗前显著降低,且观察组上述指标均明显低于对照组(P<0.05);治疗前,两组LVESD、LVEF、6min步行距离水平无明显差异;治疗后,两组LVEF、6 min步行距离水平均较治疗前显著升高,且观察组高于对照组,两组LVESD水平较治疗前显著下降,且观察组显著低于对照组(P<0.05);治疗前,两组心肌纤维化指标水平无明显差异;治疗后,两组LN、HA水平均显著降低,且观察组上述指标均低于对照组(P<0.05);两组不良反应总发生率为10.64%、14.89%,组间比较差异无统计学意义(P>0.05)。结论:托伐普坦联合氢氯噻嗪治疗慢性心力衰竭的临床效果显著优于单用氢氯噻嗪治疗,可有效改善患者血清Hcy、NTpro-BNP水平,且不会增加不良反应。Objective:To study the efficacy of topvastatin combined with hydrochlorothiazide in the treatment of chronic heart failure and its effect on the serum Homocysteine(Hcy),n-terminal brain natriuretic peptide precursor(NTproBNP)levels.Methods:94 patients with chronic heart failure who were treated in our hospital from January 2018 to December 2019 were selected and divided into the observation group(n=47)and the control group(n=47)by drawing lots.The control group was treated with hydrochlorothiazide,while the observation group was treated with topvastatin on the basis of control group.The clinical efficacy,changes of serum Hcy,NTproBNP,LVESD,LVEF,6min walking distance,laminin(LN),hyaluronic acid(HA)levels before and after treatment and incidence of adverse reactions were compared between the two groups.Results:After treatment,the total effective rate of the two groups was 93.62%and 74.47%,respectively,which was significantly higher in the observation group than in the control group(P<0.05).Before treatment,there was no significant difference in the serum Hcy and NTproBNP levels between the two groups.After treatment,serum levels of Hcy and NTproBNP in the two groups were significantly lower than those before treatment,and the above indexes in the observation group were significantly lower than those in the control group(P<0.05).Before treatment,there was no significant difference in the LVESD,LVEF and 6 min walking distance between the two groups.After treatment,the level of LVEF and 6 min walking distance in both groups was significantly higher than that before treatment,and the level of LVESD in the observation group was significantly higher than that in the control group,while the level of LVESD in the two groups was significantly lower than that before treatment,and the level of LVESD in the observation group was significantly lower than that in the control group(P<0.05).Before treatment,there was no significant difference in myocardial fibrosis index between the two groups.After treatment,the levels of LN and

关 键 词：托伐普坦 氢氯噻嗪 慢性心力衰竭 同型半胱氨酸 N末端脑钠肽前体 

分 类 号：R541.61[医药卫生—心血管疾病]