康复锻炼联合尼可地尔对老年慢性心力衰竭患者心功能、氧化应激及血清BNP水平的影响  

Effects of rehabilitation exercise combined with Nicorandil on cardiac function,oxidative stress,and serum BNP levels in elderly patients with chronic heart failure

作　　者：张婷 韩跃虎 赵荣 程洁 高洁 吕向妮 孙成军 王立 Zhang Ting;Han Yuehu;Zhao Rong;Cheng Jie;Gao Jie;Lyu Xiangni;Sun Chengjun;Wang Li(Department of Cardiovascular Surgery,The First Affiliated Hospital of Air Force Medical University,Xi'an 710032,China)

机构地区：[1]空军军医大学第一附属医院心血管外科,西安710032

出　　处：《保健医学研究与实践》2024年第2期81-87,共7页Health Medicine Research and Practice

基　　金：陕西省创新能力支撑计划项目(2022TD-57)。

摘　　要：目的探讨康复锻炼联合尼可地尔治疗老年慢性心力衰竭(CHF)患者的临床疗效,以期为老年CHF患者的临床治疗提供参考。方法选取2021年12月—2022年12月空军军医大学第一附属医院收治的82例老年CHF患者,按照治疗方案分为研究组(n=42)和对照组(n=40)。对照组患者采用常规治疗联合康复锻炼,研究组患者在对照组基础上联用尼可地尔治疗。比较2组患者的临床疗效,治疗前后血清脑利尿钠肽(BNP)、心功能指标[左心室舒张末期内径(LVDED)、左心室射血分数(LVEF)和左心室收缩末期内径(LVSED)]、6 min步行试验(6MWT)距离、氧化应激指标、血管内皮功能及不良反应发生情况。结果研究组患者的治疗总有效率为97.62%(41/42),高于对照组的80.00%(32/40),差异有统计学意义(χ^(2)=4.831,P=0.028)。治疗前,2组患者血清BNP水平比较,差异无统计学意义(P>0.05);研究组患者治疗1个月、3个月、6个月时BNP水平均低于同一时间点的对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者LVDED、LVEF、LVSED及6MWT距离比较,差异均无统计学意义(P>0.05);治疗后,研究组患者LVDED、LVSED小于对照组,LVEF、6MWT距离大于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者血清超氧化物歧化酶(SOD)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化氢酶(CAT)及丙二醛(MDA)水平比较,差异均无统计学意义(P>0.05);治疗后,研究组患者血清SOD、CSH-Px、CAT水平均高于对照组,血清MDA水平低于对照组,差异均有统计学意义(P<0.05)。治疗前,2组患者肱动脉充血后血管内径、肱动脉反应性充血后血管内径变化率、肱动脉血流量及血清一氧化氮(NO)、内皮素-1(ET-1)水平比较,差异均无统计学意义(P>0.05);治疗后,研究组患者肱动脉充血后血管内径、肱动脉反应性充血后血管内径变化率、肱动脉血流量及血清NO水平高于对照组,血清ET-1水平低于对照组,差异均有统计�Objective To investigate the clinical efficacy of rehabilitation exercise combined with nicorandil in the treatment of elderly patients with chronic heart failure(CHF),and to provide evidence for the clinical treatment of elderly CHF patients.Methods A total of 82 elderly patients with CHF admitted to The First Affiliated Hospital of Air Force Medical University from December 2021 to December 2022 were selected and allocated to a study group(n=42)and a control group(n=40)following the treatment plan.The control group received conventional treatment combined with rehabilitation exercise,while the study group received nicorandil in addition to the treatment in the control group.The clinical efficacy,brain natriuretic peptide(BNP)levels,cardiac function indicators[left ventricular end-diastolic diameter(LVDED),left ventricular ejection fraction(LVEF),and left ventricular end-systolic diameter(LVSED)],6-minute walk test(6MWT)distance,oxidative stress indicators,vascular endothelial function,and occurrence of adverse reactions were compared between the two groups.Results The overall response rate of treatment in the study group was significantly higher than that in the control group[97.62%(41/42)vs.80.00%(32/40);χ^(2)=4.831,P=0.028].Before treatment,no significant difference was observed in serum BNP levels between the two groups(P>0.05).After 1 month,3 months,and 6 months of treatment,the BNP levels in the study group were significantly lower than those in the control group at the same time points(P<0.05).Before treatment,no significant differences were found in LVDED,LVEF,LVSED,and 6MWT distance between the two groups(P>0.05).After treatment,the LVDED and LVSED in the study group were significantly smaller than those in the control group,while LVEF and 6MWT distance were significantly larger than those in the control group(P<0.05).Before treatment,no significant differences were noted in serum superoxide dismutase(SOD),glutathione peroxidase(GSH-Px),catalase(CAT),and malondialdehyde(MDA)levels between the two group

关 键 词：尼可地尔 老年慢性心力衰竭 心功能 氧化应激 脑利尿钠肽 康复锻炼 

分 类 号：R541.61[医药卫生—心血管疾病]