氯沙坦联合螺内酯治疗冠状动脉微栓塞的临床研究  

Losartan combined with spironolactone in the treatment of coronary microembolization

作　　者：朱贵家 梁国胜[1] 李忠银[1] Zhu Guijia;Liang Guosheng;Li Zhongyin(Department of Cardiology I,Puyang Oilfield General Hospital,Puyang 457001,China)

机构地区：[1]濮阳市油田总医院心内科一区,濮阳457001

出　　处：《中国实用医刊》2023年第17期95-98,共4页Chinese Journal of Practical Medicine

摘　　要：目的:探讨氯沙坦联合螺内酯治疗冠状动脉微栓塞的临床效果。方法:抽取2020年5月至2022年4月濮阳市油田总医院收治的冠状动脉微栓塞患者92例,随机分为单一组与联合组,每组46例。单一组采用氯沙坦治疗,联合组在单一组的基础上采用螺内酯治疗。比较两组治疗效果及治疗前后心功能[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)]、心室重构指标[左心室质量指数(LVMI)、左心室后壁厚度(LVPWT)、室间隔厚度(LVST)]及血清超敏C反应蛋白(hs-CRP)、基底金属蛋白酶-9(MMP-9)、金属蛋白酶组织抑制因子-1(TIMP-1)水平。结果:联合组总有效率(93.48%,43/46)高于单一组(69.57%,32/46),P<0.05。治疗后,联合组LVEF水平高于单一组,LVESD、LVEDD水平低于单一组(P<0.05);治疗后,联合组LVMI、LVPWT、LVST水平低于单一组(P<0.05);治疗后,联合组hs-CRP、MMP-9、TIMP-1水平低于单一组(P<0.05)。结论:氯沙坦联合螺内酯治疗冠状动脉微栓塞疗效显著,能调节hs-CRP、MMP-9、TIMP-1表达,改善患者的心功能和心室重构指标。Objective To investigate the clinical effect of losartan combined with spironolactone in the treatment of coronary microembolization.Methods Ninety-two patients with coronary microembolization treated in Puyang Oilfield General Hospital from May 2020 to April 2022 were selected,and they were divided into single group and combined group randomly,with 46 cases in each group.The single group was treated with losartan,and the combined group was treated with spironolactone based on the treatment of the single group.The treatment efficacy of the two groups were compared,The cardiac function assessed by left ventricular ejection fraction(LVEF),left ventricular end systolic diameter(LVESD)and left ventricular end diastolic diameter(LVEDD),ventricular remodeling indexes,including left ventricular mass index(LVMI),left ventricular posterior wall thickness(LVPWT)and left ventricular septum thickness(LVST),serum hypersensitivity C-reactive protein(hs-CRP)level,basal matrix metalloproteinase-9(MMP-9)level and tissue inhibitor of metalloproteinase-1(TIMP-1)level were compared between the two groups before and after treatment.Results The total effective rate of the combined group(93.48%,43/46)was higher than that of the single group(69.57%,32/46),P<0.05.After treatment,the combined group had higher LVEF level,lower LVESD levels and lower LVEDD level,compared with the single group(P<0.05).After treatment,levels of LVMI,LVPWT and LVST in the combined group were lower than those in the single group(P<0.05).After treatment,the levels of hs-CRP,MMP-9 and TIMP-1 in the combined group were lower than those in the single group(P<0.05).Conclusions Losartan combined with spironolactone is effective in the treatment of coronary microembolization,which can regulate the expression of hs-CRP,MMP-9 and TIMP-1,and improve cardiac function and ventricular remodeling indexes.

关 键 词：氯沙坦 冠状动脉微栓塞 螺内酯 心功能 

分 类 号：R541.4[医药卫生—心血管疾病]