巯甲丙脯酸联合重组人脑利钠肽治疗充血性心力衰竭的效果及对细胞间黏附分子-1和促甲状腺素水平的影响  

The effect of aceinhibitor captopril combined with recombinant human brain natriuretic peptide on congestive heart failure and the levels of soluble intercellular adhesion molecule-1 and thyroid stimulating hormone

作　　者：龚玲[1] 刘玉芳[1] 吴勇[1] GONG Ling;LIU Yu-fang;WU Yong(Department of cardiology Zigong Third People’s Hospital,Zigong 643020,China)

机构地区：[1]自贡市第三人民医院心内科,四川省自贡市643020

出　　处：《中国心血管病研究》2023年第10期943-950,共8页Chinese Journal of Cardiovascular Research

摘　　要：目的研究巯甲丙脯酸联合重组人脑利钠肽对充血性心力衰竭患者细胞间黏附分子-1(sICAM-1)、促甲状腺素(TSH)水平的影响。方法以本院2018年6月至2019年5月间收治的106例充血性心力衰竭患者作为对象,以随机数字表法作为依据对其进行分组,单独组53例与联合治疗组53例,各组患者分别进行治疗。两组分别以心功能分级进行亚组分析,将单独组分为单独Ⅱ级组、单独Ⅲ级组、单独Ⅳ级组,将联合治疗组分为联合Ⅱ级组、联合Ⅲ级组、联合Ⅳ级组。检测各组患者治疗前后心功能指标、去甲肾上腺素(NE)、内皮素-1(ET-1)、N末端脑利钠肽前体(NT-proBNP)、白介素-6(IL-6)、C-反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、可溶性细胞间黏附分子-1(sICAM-1)、促甲状腺激素(TSH)、三碘甲状腺原氨酸(T3)水平,统计对比各组患者的治疗有效率和不良反应发生率。结果治疗后联合组患者SV是(60.12±5.92)ml、LVEF水平是(56.83±5.17)%,高于单独组的(53.27±5.06)ml与(45.61±4.20)%,CO水平是(5.86±0.75)L/min,低于单独组的(9.81±0.96)L/min(P<0.05)。治疗后联合组患者的NE是(109.21±10.64)ng/L、ET-1是(230.71±18.37)ng/L,低于单独组的(145.13±13.67)ng/L与(313.10±20.81)ng/L(P<0.05)。治疗后联合组患者的IL-6是(10.33±1.16)ng/L、CRP是(5.25±0.41)mg/L、TNF-α是(9.53±0.42)ng/L,低于单独组的(15.64±1.87)ng/L、(7.43±0.73)mg/L与(12.37±1.32)ng/L(P<0.05)。治疗后联合组患者sICAM-1是(498.34±43.57)μg/L,低于单独组的(563.28±46.27)μg/L,T3是(7.01±0.83)μmol/L。高于单独组的(4.28±0.51)μg/L(P<0.05),TSH低于单独组(P>0.05)。相比单独组,联合组治疗总有效率较高(P<0.05)。联合组患者的不良反应发生率略高于单独组,但两组比较,无统计学意义(P>0.05)。亚组分析显示,联合Ⅲ级组的总有效率比单独Ⅲ级组的更高(P<0.05)。治疗后联合Ⅱ级组CO、LVEDD、LVESD、NE、ET-1、NT-proBNP、IL-6、CRP、TNF-α、sICAM-1水Objective To investigate the effect of aceinhibitor captopril combined recombinant human brain natriuretic peptide on levels of soluble intercellular adhesion molecule-1(sICAM-1)and thyroid stimulating hormone(TSH)in the patients with congestive heart failure.Methods A total of 106 patients with congestive heart failure admitted to our hospital from June 2018 to May 2019 were taken as objects.Based on the random number table method,they were divided into groups,including 53 cases in the single group and 53 cases in the combined treatment group,and each group was treated separately.The two groups were divided into subgroups by cardiac function classification,and the individual group was divided into the independent gradeⅡgroup,independent gradeⅢgroup and the independent gradeⅣgroup;and the combined treatment group was divided into the combined gradeⅡgroup,combined gradeⅢgroup and the combined gradeⅣgroup.Cardiac function indicators,NE,ET-1,NT-probnp,IL-6,CRP,TNF-α,intercellular adhesion molecule-1(sICAM-1),thyrotrophin(TSH)and triiodothyronine(T3)levels of the patients in the two groups were measured before and after the treatment,and the effective rate and incidence of adverse reactions in the two groups were statistically compared.Results After the treatment,the SV and LVEF levels in the combination group were(60.12±5.92)mL and(56.83±5.17)%,which were higher than those in the single group(53.27±5.06)mL and(45.61±4.20)%;but CO level was(5.86±0.75)L/min,lower than that(9.81±0.96)L/min in the single group(P<0.05).After the treatment,the NE and ET-1 of the combined group were(109.21±10.64)ng/L and(230.71±18.37)ng/L,which were lower than those of the single group(145.13±13.67)ng/L and(313.10±20.81)ng/L(P<0.05).After the treatment,IL-6(10.33±1.16)ng/L,CRP(5.25±0.41)mg/L and TNF-α(9.53±0.42)ng/L of the combined group were lower than those(15.64±1.87)ng/L,(7.43±0.73)mg/L and(12.37±1.32)ng/L in the independent group(P<0.05).After the treatment,sICAM-1 in the combination group was(498.34±43.

关 键 词：巯甲丙脯酸 重组人脑利钠肽 充血性心力衰竭 促甲状腺素 

分 类 号：R541.6[医药卫生—心血管疾病]