小剂量螺内酯联合硝普钠对扩张型心肌病致心衰患者血管内皮功能及外周血sST2、sICAM-1的影响  

Effects of Low-dose Spironolactone Combined with Sodium Nitroprusside on Vascular Endothelial Function and Peripheral Blood sST2 and sICAM-1 in Patients with Heart Failure Caused by Dilated Cardiomyopathy

作　　者：崔继婷 田艳珍 宋凌慧 CUI Ji-ting;TIAN Yan-zhen;SONG Ling-hui(Department of Cardiology,Zhangjiakou First Hospital,Affiliated Hospital of Zhangjiakou University,Zhangjiakou 075000,China)

机构地区：[1]张家口市第一医院(张家口学院附属医院)心内一科,张家口075000

出　　处：《微循环学杂志》2023年第1期38-42,47,共6页Chinese Journal of Microcirculation

基　　金：河北省科学基金课题(202420-4);河北省医学科学研究课题(20191720)。

摘　　要：目的:观察小剂量螺内酯联合硝普钠对扩张型心肌病(DCM)致心力衰竭(HF)的临床疗效。方法:选取2020-07-2021-08本院收治的66例DCM所致HF患者,随机将其分为常规组(n=22)、对照组(n=22)和研究组(n=22)。常规组采用常规治疗,对照组在常规组基础上联合硝普钠治疗,研究组在对照组基础上联合小剂量螺内酯治疗。治疗3个月后分析三组患者治疗前后外周血血清内皮素(ET)、一氧化氮合酶(NOS)、一氧化氮(NO)、可溶性生长刺激表达基因2蛋白(sST2)、可溶性细胞黏附分子1(sICAM-1)水平变化,同时比较三组临床疗效及不良反应发生情况。结果:治疗前,三组患者各指标水平差异无统计学意义(P>0.05)。治疗后,三组血清ET、sST2及sICAM-1水平较治疗前均降低,血清NOS及NO水平较治疗前均升高(P<0.01);治疗后各组ET、sST2及sICAM-1水平呈常规组>对照组>研究组,研究组血清NOS、NO水平均高于常规组,差异均有统计学意义(P<0.01);治疗后,常规组与对照组血清NOS、NO水平比较差异均无统计学意义(P>0.05),研究组与对照组血清NOS、NO水平比较差异也无统计学意义(P>0.05)。研究组治疗总有效率高于对照组和常规组(P<0.01),对照组与常规组治疗总有效率差异无统计学意义(P>0.05);三组不良反应总发生率差异无统计学意义(P>0.05)。结论:小剂量螺内酯联合硝普钠治疗能有效改善DCM致HF患者血管内皮功能,减轻心肌损伤和心肌炎症,疗效良好,安全性高,具有较好的临床应用前景。Objective:To investigate the clinical efficacy of low-dose spironolactone combined with sodium nitroprusside on heart failure(HF)caused by dilated cardiomyopathy(DCM).Method:A total of 66 patients with HF caused by DCM from July 2020 to August 2021 were selected and divided into conventional group(n=22),control group(n=22)and study group(n=22)according randomization.The routine group was treated with routine treatment,the control group was treated with sodium nitroprusside on the basis of the routine group,and the study group was treated with low-dose spironolactone on the basis of the control group.The levels of serum endothelin(ET),nitric oxide synthase(NOS),nitric oxide(NO),soluble growth-stimulating gene 2(sST2)and soluble cell adhesion molecule 1(sICAM-1)in peripheral blood were compared among the three groups.The clinical efficacy and occurrence of adverse reactions of the three groups were compared.Results:After treatment,the levels of serum ET,sST2and sICAM-1in the three groups were all lower than those before treatment,and the levels of serum NOS and NO were higher than those before treatment(P>0.05).The serum levels of ET,sST2and sICAM-1in the study group and control group were lower than those in the conventional group,and the serum NOS and NO levels were higher than those in the conventional group(P<0.01).The serum levels of ET,sST2and sICAM-1in the study group were lower than those in the control group.The levels of serum NOS and NO in the study group were significantly higher than those in the conventional group(P<0.01).After treatment,there was no significant difference in serum NOS and NO levels between the routine group and the study group and the control group(P>0.05).The total effective rate of the study group was higher than that of the control group and the conventional group(P<0.01).However,there was no significant difference in the total effective rate between the control group and the conventional group(P>0.05).There was no significant difference in the total incidence of adverse reactions

关 键 词：心力衰竭 扩张型心肌疾病 螺内酯 硝普钠 可溶性生长刺激表达基因2蛋白 可溶性细胞黏附分子1 

分 类 号：R541.6[医药卫生—心血管疾病]