氯沙坦治疗心力衰竭对患者心肌氧耗及心肌缺血情况的影响  

Effects of losartan treatment on myocardial oxygen consumption and myocardial ischemia in patients with heart failure

作　　者：玄继昌 XUAN Ji-chang(Department of Cardiology,Zoucheng People’s Hospital,Zoucheng 273500,China)

机构地区：[1]邹城市人民医院心内科,273500

出　　处：《中国实用医药》2022年第2期20-23,共4页China Practical Medicine

摘　　要：目的探讨氯沙坦治疗心力衰竭对患者心肌氧耗及心肌缺血情况的影响。方法78例心力衰竭患者,采用随机数字表法分为对照组和研究组,每组39例。对照组应用常规治疗,研究组应用氯沙坦治疗。对比两组患者治疗前后心肌耗氧量、心率、舒张压、收缩压、血管紧张素Ⅱ(AngⅡ)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平及治疗后心肌缺血指标[ST段下降导联数(NST)、ST段压低总和(∑ST)]、心功能指标。结果治疗后,研究组患者心肌耗氧量、心率、舒张压、收缩压分别为(1012.23±213.03)kPa/min、(75.35±7.53)次/min、(76.52±10.52)mm Hg(1 mm Hg=0.133 kPa)、(112.56±8.22)mm Hg,均低于对照组的(1256.08±253.08)kPa/min、(81.63±8.02)次/min、(85.25±11.37)mm Hg、(127.96±10.63)mm Hg,差异具有统计学意义(P<0.05)。治疗后,研究组患者∑ST(3.72±0.42)mm、NST(3.13±0.39)低于对照组的(4.96±1.38)mm、(4.82±1.28),左心室射血分数(48.78±6.63)%高于对照组的(43.86±3.46)%,差异具有统计学意义(P<0.05)。治疗后,研究组患者AngⅡ(104.72±14.56)ng/dl、IL-6(74.82±13.21)pg/ml、TNF-α(81.48±10.77)ng/dl均低于对照组的(138.41±15.32)ng/dl、(125.36±18.22)pg/ml、(107.23±11.53)ng/dl,差异具有统计学意义(P<0.05)。结论采用氯沙坦治疗心力衰竭效果理想,可有效改善心肌缺血、心肌氧耗情况,临床应当进一步推广应用。Objective To discuss the effects of losartan treatment on myocardial oxygen consumption and myocardial ischemia in patients with heart failure.Methods A total of 78 patients with heart failure were divided into control group and research group by random numerical table,with 39 cases in each group.The control group was treated with conventional treatment,and the research group was treated with losartan.Both groups were compared in terms of myocardial oxygen consumption,heart rate,diastolic blood pressure,systolic blood pressure,angiotensinⅡ(AngⅡ),interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and myocardial ischemia indexes[number of leads of ST depression(NST),maximal voltage of ST depression(ΣST)],cardiac function indexes after treatment.Results After treatment,the myocardial oxygen consumption,heart rate,diastolic blood pressure,and systolic blood pressure of the research group were(1012.23±213.03)kPa/min,(75.35±7.53)beats/min,(76.52±10.52)mm Hg(1 mm Hg=0.133 kPa)and(112.56±8.22)mm Hg,which were lower than(1256.08±253.08)kPa/min,(81.63±8.02)beats/min,(85.25±11.37)mm Hg,(127.96±10.63)mm Hg of the control group,and the difference was statistically significant(P<0.05).After treatment,the ΣST and NST of the research group were lower than those of the control group,and the left ventricular ejection fraction was higher than that of the control group.All the differences were statistically significant(P<0.05).After treatment,the AngⅡ,IL-6,and TNF-αin the research group were lower than those in the control group,and the difference was statistically significant(P<0.05).Conclusion Losartan has an ideal effect in the treatment of heart failure,which can effectively improve myocardial ischemia and myocardial oxygen consumption,and should be further promoted and applied in clinical practice.

关 键 词：氯沙坦 心力衰竭 心肌氧耗 心肌缺血 

分 类 号：R541.6[医药卫生—心血管疾病]