环磷腺苷葡胺联合新四联方案治疗慢性心力衰竭的疗效及对心功能指标的影响  

Efficacy of meglumine adenosine cyclophosphate combined with new quadruple scheme in the treatment of chronic heart failure and its influence on cardiac function indexes

作　　者：谢兆莉 张耀堂 苏书艳 XIE Zhaoli;ZHANG Yaotang;SU Shuyan(Lianyungang 149th Hospital,Jiangsu Province,Lianyungang 222000,China)

机构地区：[1]连云港一四九医院,江苏省连云港市222000

出　　处：《临床合理用药》2025年第8期16-19,共4页Chinese Journal of Clinical Rational Drug Use

基　　金：南京医科大学康达学院科研发展基金(KD2023KYJJ152)。

摘　　要：目的 观察环磷腺苷葡胺联合新四联方案治疗慢性心力衰竭(CHF)的疗效及对心功能指标的影响。方法 选取2023年1月—2024年6月连云港一四九医院收治的CHF患者80例,采用随机数字表法分为强心剂联合组和新四联方案组,各40例。新四联方案组给予新四联方案,强心剂联合组在新四联方案组基础上给予环磷腺苷葡胺治疗。治疗12周后比较2组临床疗效,治疗前后心功能指标[左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF)、心脏指数(CI)]、神经分泌因子[N末端脑利尿钠肽前体(NT-proBNP)、抗利尿激素(ADH)、肾素活性(PRA)]、血管内皮功能指标[血管舒张功能(FMD)、内皮素-1(ET-1)、一氧化氮(NO)]、明尼苏达心力衰竭生活质量量表(MLHFQ)评分,不良反应。结果 强心剂联合组总有效率高于新四联方案组(92.50%vs. 72.50%,χ^(2)=5.541,P=0.019)。治疗12周后,2组LVESD、LVEDD小于治疗前,LVEF、CI高于治疗前,且强心剂联合组变化幅度大于新四联方案组(P<0.05或P<0.01);2组NT-proBNP、ADH、PRA水平低于治疗前,且强心剂联合组NT-proBNP、ADH水平低于新四联方案组(P<0.01);2组FMD及NO水平较治疗前升高,ET-1水平较治疗前降低,且强心剂联合组变化幅度大于新四联方案组(P<0.01);2组MLHFQ评分较治疗前降低,且强心剂联合组变化幅度大于新四联方案组(P<0.01)。强心剂联合组与新四联方案组不良反应总发生率比较差异无统计学意义(12.50%vs. 10.00%,χ^(2)=0.125,P=0.723)。结论 环磷腺苷葡胺联合新四联方案治疗CHF可取得较好的临床效果,改善患者心功能,调节神经分泌因子水平,减轻血管内皮损伤,具有较高的用药安全性,保障患者的生活质量。Objective To observe the curative effect of meglumine adenosine cyclophosphate combined with new quadruple scheme on chronic heart failure(CHF)and its influence on cardiac function indexes.Methods A total of 80 CHF patients admitted to Lianyungang 149th Hospital from January 2023 to June 2024 were selected and divided into cardiotonic combination group and new quadruple solution group by random number table method,with 40 cases in each group.The new quadruple solution group was given the new quadruple scheme,and the cardiotonic combination group was given meglumine adenosine cyclophosphate on the basis of the new quadruple solution group.After 12 weeks of treatment,the clinical efficacy,changes in cardiac function indicators(LVESD,LVEDD,LVEF,CI),neurosecretory factors(NT-proBNP,ADH,PRA),vascular endothelial function indicators(FMD,ET-1,NO),MLHFQ scores before and after treatment,adverse reactions of the 2 groups were compared.Results The total effective rate of cardiotonic combination group was higher than that of new quadruple solution group(92.50%vs.72.50%,χ^(2)=5.541,P=0.019).After 12 weeks of treatment,LVESD and LVEDD in 2 groups were lower than before treatment,LVEF and CI were higher than before treatment,and the change range of cardiotonic combination group was greater than new quadruple solution group(P<0.05 or P<0.01).The levels of NT-proBNP,ADH and PRA in 2 groups were lower than before treatment,the levels of NT-proBNP and ADH in cardiotonic combination group were lower than those in new quadruple solution group(P<0.01).FMD and NO levels in 2 groups were higher than before treatment,ET-1 level was lower than before treatment,and the change range in cardiotonic combination group was greater than that in new quadruple solution group(P<0.01).MLHFQ scores in 2 groups were lower than that before treatment,and the change range in cardiotonic combination group was greater than that in new quadruple solution group(P<0.01).There was no significant difference in the total incidence of adverse reactions between

关 键 词：慢性心力衰竭 环磷腺苷葡胺 新四联方案 心功能 神经分泌因子 血管内皮功能 

分 类 号：R541.6[医药卫生—心血管疾病]