曲美他嗪联合胺碘酮治疗老年高血压心脏病的效果及对心肌重构指标的影响  

Effect of Trimetazidine Combined with Amiodarone in the Treatment of Elderly Patients with Hypertensive Heart Disease and Its Effect on Myocardial Remodeling

作　　者：李晓燕[1] LI Xiaoyan(Rongcheng People's Hospital,Shandong Province,Rongcheng 264300,China)

机构地区：[1]山东省荣成市人民医院,山东荣成264300

出　　处：《中国医学创新》2023年第10期18-22,共5页Medical Innovation of China

摘　　要：目的:探析曲美他嗪联合胺碘酮治疗老年高血压心脏病的效果及对心肌重构的影响。方法:选取2015年1月-2022年1月荣成市人民医院收治的老年高血压心脏病患者120例,使用随机数字表法将其分为观察组及对照组,各60例。对照组行胺碘酮治疗,观察组在对照组基础上加用曲美他嗪,对比两组炎症因子指标、心肌重构指标、氧化应激指标及血管活性指标。结果:治疗前,两组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶-3(MMP-3)及单核细胞p38丝裂原激活蛋白激酶(p38 MAPK)mRNA比较,差异均无统计学意义(P>0.05);治疗3个月后,两组的指标均下降,观察组均低于对照组(P<0.05)。治疗前,两组左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEDD)、左心室重量指数(LVMI)比较,差异均无统计学意义(P>0.05);治疗3个月后,两组LVEF均上升,观察组高于对照组(P<0.05);LVESD、LVEDD及LVMI均下降,观察组均低于对照组(P<0.05)。治疗前,两组超氧化物歧化酶(SOD)、丙二醛(MDA)、活性氧类(ROS)及谷胱甘肽过氧化物酶(GSH-Px)比较,差异均无统计学意义(P>0.05);治疗3个月后,两组的SOD及GSH-Px均上升,观察组均高于对照组(P<0.05);MDA及ROS均下降,观察组均低于对照组(P<0.05)。治疗前,两组一氧化氮(NO)、6-酮-前列腺素1α(6-Keto-PGF1α)、内皮素-1(ET-1)、血栓素B2(TXB2)比较,差异均无统计学意义(P>0.05);治疗3个月后,两组的NO及6-Keto-PGF1α均上升,观察组高于对照组(P<0.05);ET-1及TXB2均下降,观察组低于对照组(P<0.05)。结论:曲美他嗪联合胺碘酮可有效减轻老年高血压心脏病患者的炎症反应及氧化应激反应,抑制心肌重构并调节血管内皮功能,效果优异。Objective:To investigate the effect of Trimetazidine combined with Amiodarone in the treatment of hypertensive heart disease in the elderly and the effect on myocardial remodeling.Method:One hundred and twenty elderly patients with hypertensive heart disease admitted to Rongcheng People's Hospital from January 2015 to January 2022 were selected and divided into observation group and control group using the random number table method,with 60 cases each.The control group was treated with Amiodarone,and the observation group was treated with Trimetazidine on top of the control group.The inflammatory factor indexes,myocardial remodeling indexes,oxidative stress indexes and vasoactive indexes of the two groups were compared.Result:Before treatment,there were no significant differences in the mRNA of interleukin-6(IL-6),tumour necrosis factor-α(TNF-α),matrix metalloproteinase-3(MMP-3)and monocyte p38 mitogen-activated protein kinase(p38 MAPK)between the two groups(P>0.05);after 3 months of treatment,the indexes in both groups decreased,the observation group were lower than those of the control group(P<0.05).Before treatment,there were no significant differences in left ventricular ejection fraction(LVEF),left ventricular end-systolic internal diameter(LVESD),left ventricular end-diastolic internal diameter(LVEDD)and left ventricular weight index(LVMI)between the two groups(P>0.05);after 3 months of treatment,LVEF increased in both groups,the observation group was higher than that of the control group(P<0.05);LVESD,LVEDD and LVMI all decreased,and the observation group were lower than those of the control group(P<0.05).Before treatment,there were no significant differences in superoxide dismutase(SOD),malondialdehyde(MDA),reactive oxygen species(ROS)and glutathione peroxidase(GSH-Px)between the two groups(P>0.05);after 3 months of treatment,SOD and GSH-Px increased in both groups,the observation group were higher than those of the control group(P<0.05);MDA and ROS decreased,the observation group were lower than those

关 键 词：曲美他嗪 老年高血压心脏病 心肌重构 炎症反应 氧化应激 血管活性 

分 类 号：R541.3[医药卫生—心血管疾病]