心脏瓣膜置换术后应用厄贝沙坦联合比索洛尔对风湿性心脏瓣膜病患者心肾功能及炎性因子水平的影响
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摘要
目的探讨风湿性心脏瓣膜病心脏瓣膜置换术后应用厄贝沙坦联合比索洛尔的临床价值。方法将2017年2月—2018年6月收治的86例心脏瓣膜置换术后风湿性心脏瓣膜病患者以随机数字表法分组,观察组与对照组各43例,对照组术后采用厄贝沙坦治疗,观察组术后采用厄贝沙坦联合比索洛尔治疗,对两组患者术后心肾功能及炎性因子水平进行观察。结果两组患者治疗前的左心室射血分数(LVEF)、心肌钙蛋白T(c Tn-T)、血肌酐(Scr)及尿素氮(BUN)水平差异无统计学意义(P>0.05),观察组治疗后的上述指标分别为(53.58±2.63)%、(3.21±0.39)μg/L、(78.52±9.37)μmol/L、(8.57±1.06)mmol/L均与对照组(44.63±2.85)%、(3.87±0.34)μg/L、(85.74±10.63)μmol/L、(9.24±1.12)mmol/L相比差异有统计学意义(t=15.133、8.364、3.341、2.849,P=0.000、0.000、0.001、0.005);两组治疗前的高敏C-反应蛋白(hs-CRP)、白细胞介素-1(IL-1)、肿瘤坏死因子-α(TNF-α)等水平差异无统计学意义(P>0.05),观察组治疗后上述指标分别为(4.82±1.23)mg/L、(14.28±3.67)pg/mL、(8.37±1.52)pg/mL与对照组(9.34±1.97)mg/L、(32.57±4.13)pg/mL、(15.72±2.64)pg/mL比较差异有统计学意义(t=12.762、21.707、15.821,P=0.000、0.000、0.000);观察组术后并发症发生率为2.33%,明显低于对照组16.28%(χ~2=4.961,P=0.026)。结论心脏瓣膜置换术后应用厄贝沙坦联合比索洛尔可改善风湿性心脏瓣膜病患者心肾功能,也能控制炎性因子水平,减少术后并发症发生,值得推广。
Objective To investigate the clinical value of irbesartan combined with bisoprolol after rheumatic valvular heart disease.Methods 86 patients with rheumatic valvular heart disease who underwent heart valve replacement from February 2017 to June 2018 were randomly assigned to a random number table. The observation group and the control group were each 43 cases. The control group adopted irbesartan treatment, irbesartan combined with bisoprolol was used in the observation group. The postoperative heart and kidney function and inflammatory factor levels were observed in the two groups. Results There were no significant differences in left ventricular ejection fraction(LVEF), cardiac troponin T(cTn-T), serum creatinine(Scr) and urea nitrogen(BUN) levels between the two groups(P>0.05). The above indicators were(53.58±2.63)%,(3.21±0.39) μg/L,(78.52±9.37) μmol/L, and(8.57±1.06) mmol/L,respectively, compared with the control group(44.63±2.85)%,(3.87±0.34) μg/L,(85.74±10.63) μmol/L,(9.24±1.12) mmol/L were significantly different(t=15.133,8.364,3.341,2.849, P=0.000,0.000,0.001,0.005); There was no significant difference in the levels of high-sensitivity C-reactive protein(hs-CRP), interleukin-1(IL-1) and tumor necrosis factor-α(TNF-α) before treatment(P>0.05).The above indicators after treatment in the observation group were(4.82±1.23) mg/L,(14.28±3.67) pg/mL,(8.37±1.52) pg/mL and the control group(9.34±1.97) mg/L,(32.57± 4.13)pg/mL There was significant difference between pg/mL and(15.72±2.64) pg/mL(t=12.762,21.707,15.821, P=0.000,0.000,0.000). The postoperative complication rate of the observation group was 2.33%, which was significantly lower. In the control group 16.28%(χ~2= 4.961, P=0.026). Conclusion The application of irbesartan combined with bisoprolol after heart valve replacement can improve the heart and kidney function of patients with rheumatic valvular heart disease, and can also control the level of inflammatory factors and reduce postoperative complications. It is worthy of promotion.
Objective To investigate the clinical value of irbesartan combined with bisoprolol after rheumatic valvular heart disease.Methods 86 patients with rheumatic valvular heart disease who underwent heart valve replacement from February 2017 to June 2018 were randomly assigned to a random number table. The observation group and the control group were each 43 cases. The control group adopted irbesartan treatment, irbesartan combined with bisoprolol was used in the observation group. The postoperative heart and kidney function and inflammatory factor levels were observed in the two groups. Results There were no significant differences in left ventricular ejection fraction(LVEF), cardiac troponin T(cTn-T), serum creatinine(Scr) and urea nitrogen(BUN) levels between the two groups(P>0.05). The above indicators were(53.58±2.63)%,(3.21±0.39) μg/L,(78.52±9.37) μmol/L, and(8.57±1.06) mmol/L,respectively, compared with the control group(44.63±2.85)%,(3.87±0.34) μg/L,(85.74±10.63) μmol/L,(9.24±1.12) mmol/L were significantly different(t=15.133,8.364,3.341,2.849, P=0.000,0.000,0.001,0.005); There was no significant difference in the levels of high-sensitivity C-reactive protein(hs-CRP), interleukin-1(IL-1) and tumor necrosis factor-α(TNF-α) before treatment(P>0.05).The above indicators after treatment in the observation group were(4.82±1.23) mg/L,(14.28±3.67) pg/mL,(8.37±1.52) pg/mL and the control group(9.34±1.97) mg/L,(32.57± 4.13)pg/mL There was significant difference between pg/mL and(15.72±2.64) pg/mL(t=12.762,21.707,15.821, P=0.000,0.000,0.000). The postoperative complication rate of the observation group was 2.33%, which was significantly lower. In the control group 16.28%(χ~2= 4.961, P=0.026). Conclusion The application of irbesartan combined with bisoprolol after heart valve replacement can improve the heart and kidney function of patients with rheumatic valvular heart disease, and can also control the level of inflammatory factors and reduce postoperative complications. It is worthy of promotion.
引文
[1]肖晶晶.单极与双极射频消融在风湿性心脏瓣膜病患者临床治疗中的疗效对比分析[J].中国现代医生,2018,56(14):27-29.
[2]赵亮,彭晓波,陈劲进,等.三维成形环治疗风湿性心脏瓣膜病继发性三尖瓣关闭不全的疗效观察[J].中国医药科学,2018,8(3):20-22.
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[4]李武昌.比索洛尔、螺内酯和依那普利联合治疗风湿性心脏瓣膜病慢性心力衰竭的疗效研究[J].中国疗养医学,2017,26(5):518-520.
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[6]张静静,张金国,杜艳艳,等.风湿性心脏瓣膜病瓣膜置换术后并发感染性心内膜炎一例报道并文献复习[J].中国全科医学,2017,20(19):2423-2426.
[7]张桥,李春莉.比索洛尔联合厄贝沙坦治疗慢性心力衰竭的疗效观察[J].中国医院用药评价与分析,2016,16(3):324-326.
[8]姜雪.厄贝沙坦和比索洛尔联合治疗慢性心力衰竭的临床疗效评价[J].中国处方药,2016,27(2):83-84.
[9]侯鹏举.比索洛尔、依那普利和螺内酯联合治疗风湿性心脏瓣膜病慢性心力衰竭的疗效[J].中国医药指南,2016,14(31):54.
[10]蒋芳萍,宁靓,杨波,等.比索洛尔联合常规三联疗法对风湿性心脏瓣膜病合并慢性心力衰竭患者疗效及相关指标的影响[J].中国药房,2016,27(18):2511-2513.
[11]张超,王登峰,张壮,等.厄贝沙坦与重组人脑利钠肽对风湿性心脏病瓣膜置换术后病人心肾功能的影响[J].中西医结合心脑血管病杂志,2018,16(8):103-106.
[12]姚宏英,杨勇,洪涛,等.比索洛尔、依那普利及螺内酯三联疗法对风湿性心脏瓣膜病合并慢性心力衰竭患者LVEF、LVEDD以及LVESD的影响[J].中国老年学杂志,2016,36(16):3944-3945.
[2]赵亮,彭晓波,陈劲进,等.三维成形环治疗风湿性心脏瓣膜病继发性三尖瓣关闭不全的疗效观察[J].中国医药科学,2018,8(3):20-22.
[3]丁军.风湿性心脏瓣膜病患者行瓣膜置换术的临床治疗效果观察[J].现代诊断与治疗,2017,28(12):2292-2293.
[4]李武昌.比索洛尔、螺内酯和依那普利联合治疗风湿性心脏瓣膜病慢性心力衰竭的疗效研究[J].中国疗养医学,2017,26(5):518-520.
[5]杨恒.40例风湿性心脏瓣膜病人工瓣膜置换术临床应用观察[J].河南外科学杂志,2017,23(5):78-79.
[6]张静静,张金国,杜艳艳,等.风湿性心脏瓣膜病瓣膜置换术后并发感染性心内膜炎一例报道并文献复习[J].中国全科医学,2017,20(19):2423-2426.
[7]张桥,李春莉.比索洛尔联合厄贝沙坦治疗慢性心力衰竭的疗效观察[J].中国医院用药评价与分析,2016,16(3):324-326.
[8]姜雪.厄贝沙坦和比索洛尔联合治疗慢性心力衰竭的临床疗效评价[J].中国处方药,2016,27(2):83-84.
[9]侯鹏举.比索洛尔、依那普利和螺内酯联合治疗风湿性心脏瓣膜病慢性心力衰竭的疗效[J].中国医药指南,2016,14(31):54.
[10]蒋芳萍,宁靓,杨波,等.比索洛尔联合常规三联疗法对风湿性心脏瓣膜病合并慢性心力衰竭患者疗效及相关指标的影响[J].中国药房,2016,27(18):2511-2513.
[11]张超,王登峰,张壮,等.厄贝沙坦与重组人脑利钠肽对风湿性心脏病瓣膜置换术后病人心肾功能的影响[J].中西医结合心脑血管病杂志,2018,16(8):103-106.
[12]姚宏英,杨勇,洪涛,等.比索洛尔、依那普利及螺内酯三联疗法对风湿性心脏瓣膜病合并慢性心力衰竭患者LVEF、LVEDD以及LVESD的影响[J].中国老年学杂志,2016,36(16):3944-3945.