比索洛尔联合左旋卡尼汀、贝那普利治疗慢性心力衰竭的临床效果及对心率变异性、血浆NT-proBNP 水平、细胞因子的影响  

Clinical effect of bisoprolol combined with levocarnitine and Benapril in the treatment of chronic heart failure and its effects on heart rate variability,plasma NT-probNP level and cytokines

作　　者：周志超[1] 陈杰[1] 陈丹[1] ZHOU Zhi-chao(The third ward of cardiac departments of Zhanjiang central people's hospital,Zhanjiang,Guangdong,524000,China.)

机构地区：[1]湛江中心人民医院心内三科室,广东湛江524000

出　　处：《齐齐哈尔医学院学报》2021年第5期382-386,共5页Journal of Qiqihar Medical University

摘　　要：目的探析比索洛尔联合左旋卡尼汀、贝那普利治疗慢性心力衰竭(CHF)的应用价值。方法选择2018年1月—2019年12月本院收治的114例CHF患者作为研究对象,采用随机数表法分为研究组和对照组,每组各57例。两组患者均给予吸氧、强心及血管扩张等常规治疗,在此基础上给予对照组患者口服左旋卡尼汀与贝那普利,研究组在对照组基础上给予口服比索洛尔,治疗3个月后比较两组患者的临床疗效;心率与心率变异性,包括心率与正常窦性心搏间期的标准差(SDNN)、平均值的标准差(SDANN)与全程相邻窦性心搏间期之差的均方根值(RMSSD);血清炎性因子,包括白细胞介素-6(IL-6)、肿瘤坏死因子-(TNF-);血浆N端脑钠肽前体(NT-proBNP)水平;心功能指标,包括左室射血分数(LVEF)、左室舒张末期内径(LVEDD)与左室收缩末期内径(LVESD)。结果经过3个月的治疗,研究组的临床疗效总有效率为89.47%,显著高于对照组的75.44%(P<0.05);研究组的心率低于对照组(P<0.05);心率变异性各项指标(Rmssd、SDNN、SDANN)水平均高于对照组(P<0.05);研究组的血浆NT-proBNP与血清IL-6、TNF-水平均低于对照组(P<0.05);研究组的LVEF水平高于对照组(P<0.05),研究组的LVEDD、LVESD水平均低于对照组(P<0.05)。结论比索洛尔联合左旋卡尼汀、贝那普利可有效改善CHF患者的心率变异性,改善NT-proBNP、TNF-、IL-6细胞因子,平衡患者心功能,临床疗效显著,值得临床推广应用。Objective To explore the application value of bisoprolol combined with levocarnitine and Benapril in the treatment of chronic heart failure(CHF).Methods 114 patients with CHF who were treated in our hospital from January 2018 to December 2019 were selected as study subjects,and they were divided into study group(n=57)and control group(n=57)according to numerical random table method.Patients in the two groups were given routine treatment such as oxygen inhalation,cardiac stimulant application and vasodilation.On this basis,patients in the control group were given oral administration of levocarnitine and Benazepril.Patients in the study group were given oral administration of bisoprolol combined with levocarnitine and Benazepril.The treatment lasted for three months,the the efficacy;heart rate and heart rate variability,including heart rate and standard deviation of normal to normal(SDNN)intervals,standard deviation of the averages of normal to normal(SDANN)intervals,the square root of the mean of the sum of the squares of differences between adjacent NN intervals(RMSSD);serum inflammatory factors,including interleukin-6(IL-6),tumor necrosis factor-(TNF-);plasma levels of N-terminal brain natriuretic peptide(NT-probNP);cardiac function indicators including left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD),and left ventricular end-systolic diameter(LVESD)of the two groups were compared.Results After treatment,the total effective rate of clinical efficacy was 89.47%in the study group,which was significantly higher than 75.44%in the control group(P<0.05).Heart rate of study group was significantly lower than that of control group(P<0.05).and Heart rate variability(Rmssd,SDNN,and SDANN)of the study group were significantly higher than those of the control group(P<0.05).The plasma levels of NT-probNP and serum IL-6 and TNF-in the study group were significantly lower than those in the control group(P<0.05).The level of LVEF in the study group was higher than the control group,while t

关 键 词：慢性心力衰竭 比索洛尔 左旋卡尼汀 贝那普利 

分 类 号：R541.6[医药卫生—心血管疾病]