硝普钠联合美托洛尔对心力衰竭患者心肌重塑和炎性反应的影响
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摘要
目的探讨硝普钠联合美托洛尔对心力衰竭患者心肌重塑和炎性反应的影响。方法选取2016年1月至2018年6月我院收治的90例心力衰竭患者作为研究对象,根据治疗方式的不同将其分为对照组(42例)和联合组(48例)。对照组采用常规治疗+美托洛尔治疗,联合组采用常规治疗+美托洛尔+硝普钠治疗。比较两组患者治疗前、后的心肌重塑指标和炎性反应指标。结果治疗前,两组患者的LVEF、LVESD、LVEDD、LVFS比较,差异无统计学意义(P>0.05);治疗后,两组LVEF、LVESD、LVEDD、LVFS均明显改善,且联合组LVEF、LVFS明显高于对照组,LVESD、LVEDD明显低于对照组,差异均具有统计学意义(P<0.05)。治疗前,两组患者的hs-CRP、IL-6、TNF-α水平比较,差异无统计学意义(P>0.05);治疗后,两组患者的hs-CRP、IL-6、TNF-α水平均显著降低,且联合组明显低于对照组,差异有统计学意义(P<0.05)。结论在心力衰竭患者的临床治疗中,硝普钠联合美托洛尔可以改善患者的心肌重塑指标,减轻机体的炎性反应,值得临床推广应用。
Objective To explore the effect of sodium nitroprusside combined with metoprolol on myocardial remodeling and inflammatory response in patients with heart failure. Methods Ninety patients with heart failure admitted in our hospital from January 2016 to June 2018 were selected as the research objects. The patients were divided into control group(42 cases) and combined group(48 cases) according to the different treatment methods. The control group was treated with routine therapy +metoprolol, and the combined group was treated with routine therapy +metoprolol +sodium nitroprusside. The indexes of myocardial remodeling and inflammatory response before and after treatment of the two groups were compared. Results Before treatment, there were no significant differences in LVEF, LVESD, LVEDD and LVFS between the two groups(P>0.05); after treatment, LVEF, LVESD, LVEDD and LVFS of the two groups improved significantly, and LVEF and LVFS of the combined group were significantly higher than those of the control group, while LVESD and LVEDD of the combined group were significantly lower than those of the control group, the differences were statistically significant(P<0.05). Before treatment, there were no significant differences in the levels of hs-CRP, IL-6 and TNF-α between the two groups(P>0.05); after treatment, the levels of hs-CRP, IL-6 and TNF-α in the two groups decreased significantly, and those of the combined group were significantly lower than the control group(P <0.05).Conclusion In the clinical treatment of heart failure, sodium nitroprusside combined with metoprolol can improve the indexes of myocardial remodeling and alleviate inflammatory response of patients, which is worthy of clinical promotion and application.
Objective To explore the effect of sodium nitroprusside combined with metoprolol on myocardial remodeling and inflammatory response in patients with heart failure. Methods Ninety patients with heart failure admitted in our hospital from January 2016 to June 2018 were selected as the research objects. The patients were divided into control group(42 cases) and combined group(48 cases) according to the different treatment methods. The control group was treated with routine therapy +metoprolol, and the combined group was treated with routine therapy +metoprolol +sodium nitroprusside. The indexes of myocardial remodeling and inflammatory response before and after treatment of the two groups were compared. Results Before treatment, there were no significant differences in LVEF, LVESD, LVEDD and LVFS between the two groups(P>0.05); after treatment, LVEF, LVESD, LVEDD and LVFS of the two groups improved significantly, and LVEF and LVFS of the combined group were significantly higher than those of the control group, while LVESD and LVEDD of the combined group were significantly lower than those of the control group, the differences were statistically significant(P<0.05). Before treatment, there were no significant differences in the levels of hs-CRP, IL-6 and TNF-α between the two groups(P>0.05); after treatment, the levels of hs-CRP, IL-6 and TNF-α in the two groups decreased significantly, and those of the combined group were significantly lower than the control group(P <0.05).Conclusion In the clinical treatment of heart failure, sodium nitroprusside combined with metoprolol can improve the indexes of myocardial remodeling and alleviate inflammatory response of patients, which is worthy of clinical promotion and application.
引文
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[12]程丽森.老年原发性高血压伴心力衰竭采用贝那普利联合美托洛尔治疗对血压、心率及心功能的影响[J].中国初级卫生保健,2017,31(3):73-75.
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[14]梁家华,姜晨光,江晓涛,等.稳心颗粒联合美托洛尔治疗高血压心脏病合并室性早搏疗效的Meta分析和试验序贯分析[J].中西医结合心脑血管病杂志,2019,17(2):161-169.
[2]李堪董,赵圣吉,史丽.曲美他嗪联合美托洛尔治疗老年冠心病合并心力衰竭的临床研究[J].中国临床药理学杂志,2018,34(5):507-510.
[3]高东峰.硝普钠联合多巴胺治疗老年顽固性心衰的临床疗效观察[J].临床医学研究与实践,2016,1(20):103.
[4]杨涛,杨露,海峰,等.硝普钠与多巴胺联用治疗难治性心衰患者的临床疗效[J].西部医学,2017,29(12):1676-1679.
[5]陆千军.硝普钠联合多巴胺对急性心力衰竭患者血流动力学和肾功能影响研究[J].陕西医学杂志,2017,46(1):105-108.
[6]赵志华.顽固性心衰患者经硝普钠联合多巴胺与呋塞米治疗的临床效果[J].临床医学研究与实践,2017,2(25):33-34.
[7]左鸿雁,熊鹿,张博利.硝普钠联合多巴胺治疗难治性心衰患者的疗效及对相关指标的影响[J].医学临床研究,2018,35(4):687-689.
[8]洪征.美托洛尔联合心衰宁合剂对慢性心力衰竭患者心肌重构及心脏功能的影响分析[J].中国医师进修杂志,2014,37(25):13-15.
[9]薛蓉.硝普钠与美托洛尔联合用药治疗慢性心力衰竭疗效观察[J].航空航天医学杂志,2014,25(10):1427-1428.
[10]李蕊萍.美托洛尔联合贝那普利治疗老年高血压合并心力衰竭对患者心功能的影响[J].中外医学研究,2018,16(9):155-156.
[11]毛玉娟.美托洛尔联合贝那普利治疗老年高血压合并心力衰竭对患者心脏功能的影响[J].当代医药论丛,2018,16(5):164-165.
[12]程丽森.老年原发性高血压伴心力衰竭采用贝那普利联合美托洛尔治疗对血压、心率及心功能的影响[J].中国初级卫生保健,2017,31(3):73-75.
[13]唐安平.美托洛尔联合硝苯地平缓释片治疗高血压病80例观察[J].疑难病杂志,2008,7(8):477-478.
[14]梁家华,姜晨光,江晓涛,等.稳心颗粒联合美托洛尔治疗高血压心脏病合并室性早搏疗效的Meta分析和试验序贯分析[J].中西医结合心脑血管病杂志,2019,17(2):161-169.