托伐普坦治疗慢性心力衰竭的疗效及对血清TIMP-1、MMP-9水平的影响  

Therapeutic effect of tolvaptan on chronic heart failure and its impact on serum levels of TIMP-1 and MMP-9

作　　者：周坤[1] 陈庭燕[1] ZHOU Kun;CHEN Ting-yan(Department of Cardiology,Central Hospital of Ankang City,Ankang,Shaanxi,725000,China)

机构地区：[1]陕西省安康市中心医院心血管内科,陕西安康725000

出　　处：《心血管康复医学杂志》2021年第1期46-50,共5页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:研究托伐普坦治疗慢性心力衰竭(CHF)的疗效及对血清基质金属蛋白酶抑制剂(TIMP)-1、基质金属蛋白酶(MMP)-9水平的影响。方法:选择我科CHF患者218例,随机均分为常规治疗组与托伐普坦组(在常规治疗的基础上加用托伐普坦治疗)。连续治疗90d,观察两组治疗前后左室收缩末期内径(LVESd)、LVEF、左室舒张末期内径(LVEDd);平均肺动脉压(MPAP)、平均肺毛细血管楔压(MPCWP)、心排血量(CO)等指标,血清TIMP-1、MMP-9水平,以及疗效和不良反应。结果:治疗后,与常规治疗组比较,托伐普坦组LVESd[(49.33±5.22)mm比(42.54±4.41)mm]、LVEDd[(60.89±6.26)mm比(56.89±5.79)mm]显著缩小,LVEF[(42.79±4.45)%比(46.49±4.81)%],CO[(3.32±0.36)L/min比(3.72±0.39)L/min]及血清TIMP-1[(3.59±0.37)μg/L比(3.80±0.41)μg/L]水平,总有效率(75.23%比89.91%)显著提高,MPAP[(33.48±3.49)mmHg比(27.47±2.85)mmHg]、MPCWP[(22.19±2.33)mmHg比(19.07±2.18)mmHg]及血清MMP-9[(160.75±17.17)μg/L比(148.85±16.08)μg/L]水平均显著降低(P均<0.01)。两组均未见显著不良反应。结论:托伐普坦可显著改善CHF患者心功能及血流动力学,稳定心肌细胞功能,疗效显著,安全可靠。Objective:To study therapeutic effect of tolvaptan on CHF and its impact on serum levels of tissue inhibitor of metalloproteinases(TIMP)-1 and matrix metalloproteinase(MMP)-9.Methods:A total of 218 CHF patients from our department were randomly and equally divided into routine treatment group and tolvaptan group(received tolvaptan based on routine treatment),both groups were treated for 90d.Left ventricular end-systolic dimension(LVESd),left ventricular end-diastolic dimension(LVEDd),mean pulmonary arterial pressure(MPAP),mean pulmonary capillary wedge pressure(MPCWP),cardiac output(CO),serum levels of TIMP-1 and MMP-9 before and after treatment,therapeutic effect and adverse reactions were observed between two groups.Results:Compared with routine treatment group after treatment,there were significant reductions in LVESd[(49.33±5.22)mm vs.(42.54±4.41)mm]and LVEDd[(60.89±6.26)mm vs.(56.89±5.79)mm],and significant rise in LVEF[(42.79±4.45)%vs.(46.49±4.81)%],CO[(3.32±0.36)L/min vs.(3.72±0.39)L/min]and serum TIMP-1 level[(3.59±0.37)μg/L vs.(3.80±0.41)μg/L],total effective rate(75.23%vs.89.91%);and significant reductions in MPAP[(33.48±3.49)mmHg vs.(27.47±2.85)mmHg],MPCWP[(22.19±2.33)mmHg vs.(19.07±2.18)mmHg]and serum MMP-9 level[(160.75±17.17)μg/L vs.(148.85±16.08)μg/L]in tolvaptan group,P<0.01 all.No obvious adverse reactions were found in either group.Conclusion:Tolvaptan can significantly improve heart function and hemodynamics,stabilize myocardial cell function with significant therapeutic effect in CHF patients.It is safe and reliable.

关 键 词：心力衰竭 基质金属蛋白酶9 托伐普坦 

分 类 号：R541.61[医药卫生—心血管疾病]