曲美他嗪联合布美他尼对慢性充血性心力衰竭患者的影响  

Effect of trimetazidine combined with bumetanide in patients with chronic congestive heart failure

作　　者：陈永耀 张子云[1] 刘明 Chen Yong-yao;Zhang Zi-yun;Liu Ming(Department of Cardiology,Henan Hongli Hospital,Xinxiang 453000,Henan,Chian;Department of Cardiology,The First Affiliated Hospital of Xinxiang Medical College,Xinxiang 453000,Henan,China)

机构地区：[1]河南宏力医院心内科,河南新乡453000 [2]新乡医学院第一附属医院心内科,河南新乡453000

出　　处：《四川生理科学杂志》2025年第3期543-545,633,共4页

摘　　要：目的:探讨慢性充血性心力衰竭(Chronic congestive heart failure,CCHF)患者应用曲美他嗪联合布美他尼治疗的效果及其对血管内皮功能及血清学指标的影响。方法:回顾性分析2022年3月至2024年3月我院收治的CCHF患者(118例)的临床资料,根据治疗方案不同分为对照组和联合组(n=59),两组分别予以布美他尼注射液2 mg+0.9%氯化钠注射液250 mL(1次·d^(-1))静滴,以及曲美他嗪(35 mg·次-1,2次·d^(-1))联合布美他尼治疗,均连续治疗14 d。比较两组临床疗效,于治疗前后采用全数字彩色多普勒超声诊断仪检测心功能指标,如[左室射血分数(Left ventricular ejection fraction,LVEF)、舒张早期/舒张晚期最大血流速度(Maximal velocity of early diastolic mitral valve/maximal velocity of late diastolic mitral valve,E/A)、心输出量(Cardiac output,CO)、每搏输出量(Stroke volume,SV)];应用酶联免疫吸附法(Enzyme linked immunosorbent assay,ELISA)检测血清血管性血友病因子(Von Willebrand factor,vWF)、可溶性细胞间黏附分子-1(Soluble intercellular adhesion molecule-1,sICAM-1)、超敏C反应蛋白(High sensitive C-reactive protein,hs-CRP)、肿瘤坏死因子-α(Tumor necrosis factor-α,TNF-α)水平;双抗体夹心法测定内皮素-1(Endothelin-1,ET-1)、血管内皮生长因子(Vascular endothelial growth factor,VEGF)水平;硝酸还原酶法检测一氧化氮(Nitric oxide,NO)水平;同时统计两组不良反应发生率。结果:与对照组临床总有效率(81.36%)相比,联合组总有效率(94.92%)明显较高(P<0.05);联合组治疗后LVEF、E/A、CO、SV均明显高于对照组(P<0.05);治疗后联合组血清NO、VEGF水平较对照组高,ET-1、vWF水平较对照组低(P<0.05);联合组治疗后血清hs-CRP、sICAM-1、TNF-α水平降低幅度均大于对照组(P<0.05);联合组与对照组不良反应总发生率相比,无明显差异(P>0.05)。结论:CCHF患者经曲美他嗪联合布美他尼治疗效果显著,可有效改善患者心功能及血管�Objective:To investigate the effect of trimetazidine combined with bumetanide in patients with chronic congestive heart failure(CCHF)and its effect on vascular endothelial function and serological indexes.Methods:A retrospective analysis was conducted on the clinical data of 118 patients with CCHF admitted to our hospital from March 2022 to March 2024.The patients were divided into a control group and a combined group(n=59)according to different treatment plans.Both groups were treated with bumetanide injection 2 mg+0.9%sodium chloride injection 250 mL(once·day-1)intravenously,and trimetazidine(35 mg·time-1,twice·day-1)combined with bumetanide treatment,all for 14 consecutive days.The clinical efficacy of the two groups was compared.Before and after treatment,cardiac function indicators were measured using a full-digital color Doppler ultrasound diagnostic instrument,such as left ventricular ejection fraction(LVEF),maximal velocity of early diastolic mitral valve/maximal velocity of late diastolic mitral valve(E/A),cardiac output(CO),stroke volume(SV);serum levels of Von Willebrand factor(vWF),soluble intercellular adhesion molecule-1(sICAM-1),high sensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α)were detected using enzyme-linked immunosorbent assay(ELISA).The levels of endothelin^(-1)(ET-1)and vascular endothelial growth factor(VEGF)were measured by the double antibody sandwich method.The nitric oxide(NO)level was detected by the nitrate reductase method.The incidence of adverse reactions in the two groups was also calculated.Results:Compared with the control group(81.36%),the combined group had a significantly higher total effective rate(94.92%)(P<0.05),and the LVEF,E/A,CO,and SV levels in the combined group were significantly higher than those in the control group(P<0.05).The reduction of TNF-αlevel was higher than that of the control group(P<0.05),and there was no significant difference in the total incidence of adverse reactions between the combined group and the control group(P>0.05)

关 键 词：布美他尼 曲美他嗪 慢性充血性心力衰竭 血管内皮功能 

分 类 号：R54[医药卫生—心血管疾病]