曲美他嗪联合β受体阻滞剂对冠心病患者运动耐量、心功能及NT-proBNP水平的影响
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摘要
目的分析曲美他嗪联合β受体阻滞剂对冠心病患者运动耐量、心功能及氨基末端B型利钠肽前体(N-terminal pro-B-type natriuretic peptide,NT-pro BNP)水平的影响。方法选择2015年1月至2017年1月本院收治的100例冠心病患者为研究对象,按照随机数表法将其分为研究组和对照组,每组各50例。在常规治疗基础上,研究组患者给予曲美他嗪联合β受体阻滞剂治疗,对照组患者仅给予β受体阻滞剂治疗,治疗3个月。比较治疗前后两组患者的治疗效果、左心室舒张末期容积(left ventricular end-diastolic volume,LVEDV)、左心室收缩末期容积(left ventricular end-systolic volume,LVESV)、左心室射血分数(left ventricular ejection fraction,LVEF)和NT-pro BNP水平及运动耐量。结果研究组患者治疗有效率明显高于对照组(P<0.05)。治疗后,研究组患者达到运动终点的时间显著长于对照组,运动试验阳性例数少于对照组,最大心率小于对照组,6分钟最大步行距离大于对照组,差异均具有显著性(P_均<0.01);治疗后研究组患者的LVEDV和NT-pro BNP水平均显著低于对照组(P_均<0.05),LVEF显著高于对照组(P<0.01)。结论曲美他嗪联合β受体阻滞剂能提高冠心病的治疗效果,有效降低NT-pro BNP水平,改善患者的心功能及运动耐量。
Objective To analyze the influence of Trimetazidine combined with β-blockers on exercise tolerance, cardiac function and N-terminal pro-B-type natriuretic peptide(NT-pro BNP) in patients with coronary heart disease. Method 100 patients with coronary heart disease admitted to our hospital from January 2015 to January 2017 were selected as the research objects, according to the random number table method, they were randomly divided into two groups, with 50 cases each. All patients were given the routine treatment, and research group patients were given Trimetazidine and β-blockers drug therapy, while control group patients were only given β-blockers drug therapy. The treatment lasted for 3 months. Before and after treatment, the therapeutic effect, left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume(LVSDV), left ventricular ejection fraction(LVEF), NT-pro BNP and exercise tolerance levels of two groups were compared. Result The effective rate of research group was significantly higher than control group(P < 0.05). After treatment, the time of exercise of research group was significantly longer than that of control group, the number of positive exercise tests cases was significantly less than that of control group, and the maximum heart rate was less than that of control group, the maximum walking distance in 6 minutes was greater than that of control group(P_(all)< 0.01). After treatment, LVEDV and NT-pro BNP level of research group were significantly less than those of control group(P_(all)< 0.05), but LVEF was greater than that of control group(P < 0.01). Conclusion Trimetazidine combined with β-blockers can improve the curative effect of coronary heart disease, effectively reduce the NT-pro BNP levels, and improve cardiac function and exercise tolerance.
Objective To analyze the influence of Trimetazidine combined with β-blockers on exercise tolerance, cardiac function and N-terminal pro-B-type natriuretic peptide(NT-pro BNP) in patients with coronary heart disease. Method 100 patients with coronary heart disease admitted to our hospital from January 2015 to January 2017 were selected as the research objects, according to the random number table method, they were randomly divided into two groups, with 50 cases each. All patients were given the routine treatment, and research group patients were given Trimetazidine and β-blockers drug therapy, while control group patients were only given β-blockers drug therapy. The treatment lasted for 3 months. Before and after treatment, the therapeutic effect, left ventricular end-diastolic volume(LVEDV), left ventricular end-systolic volume(LVSDV), left ventricular ejection fraction(LVEF), NT-pro BNP and exercise tolerance levels of two groups were compared. Result The effective rate of research group was significantly higher than control group(P < 0.05). After treatment, the time of exercise of research group was significantly longer than that of control group, the number of positive exercise tests cases was significantly less than that of control group, and the maximum heart rate was less than that of control group, the maximum walking distance in 6 minutes was greater than that of control group(P_(all)< 0.01). After treatment, LVEDV and NT-pro BNP level of research group were significantly less than those of control group(P_(all)< 0.05), but LVEF was greater than that of control group(P < 0.01). Conclusion Trimetazidine combined with β-blockers can improve the curative effect of coronary heart disease, effectively reduce the NT-pro BNP levels, and improve cardiac function and exercise tolerance.
引文
[1]卢志南,孙兴国,胡盛寿,等.应用峰值摄氧量、N末端B型利钠肽原和超声心动图评估慢性心力衰竭患者心功能的比较[J].中华心血管病杂志,2015,43(3):206-211.
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[11]杨增荣,龚金龙,吴婷竹,等.6min步行试验对冠心病诊断的价值[J].心血管康复医学杂志,2016,25(6):594-598.
[12]黄玉,杨健,白海鹏,等.老年冠心病再血管化患者运动康复治疗疗效[J].中国循证心血管医学杂志,2016,8(4):480-482.
[13]何文芳,杨新春.NT-pro BNP和6MWT对曲美他嗪治疗慢性心力衰竭的疗效评估及其相关性研究[J].湖南中医药大学学报,2014,34(7):44-46,58.
[14]李平,李佑美.曲美他嗪联合美托洛尔治疗冠心病心力衰竭对血浆BNP影响及疗效观察[J].海南医学院学报,2016,22(2):126-128.
[15]王晓艳,杨侃,孙明,等.脑钠肽及和肽素水平与冠心病患者冠脉病变程度的相关性[J].中国全科医学,2010,13(2):145-147.
[16]Nichols S,Taylor C,Page R,et al.Is Cardiorespiratory Fitness Related to Cardiometabolic Health and All-Cause Mortality Risk in Patients with Coronary Heart Disease?A CARE CR Study[J].Sports Med Open,2018,4(1):22.
[17]袁慧.关注BNP与NT-pro BNP的临床应用[J].中华检验医学杂志,2012,35(10):870-873.
[18]邱宗利.B型脑利钠肽联合心肌酶谱检测在冠心病危险分层和冠脉搭桥术中的预测作用[J].实用医学杂志,2015,31(8):1259-1262.
[19]Sawaguchi T,Nakajima T,Hasegawa T,et al.Serum adiponectin and TNFαconcentrations are closely associated with epicardial adipose tissue fatty acid profiles in patients undergoing cardiovascular surgery[J].Int J Cardiol Heart Vasc,2017,18:86-95.
[20]林勇军,吴春芳,叶志荣,等.超敏C反应蛋白和脑钠肽及脂联素水平与冠心病患者相关性[J].中国临床药理学杂志,2017,33(5):463-466.
[2]中华医学会心血管病学分会,中国医师协会心血管内科医师分会,中国康复医学会心血管病专业委员会,等.心血管疾病防治指南和共识2014[M].北京:人民卫生出版社,2014.
[3]廖火城,钟思干,刘凌,等.冠心病预测评分系统的建立及评价[J].山东医药,2016,56(31):58-60.
[4]尹代江,王培书,陈健,等.β受体阻滞剂联合曲美他嗪对冠心病患者运动耐量的影响研究[J].重庆医学,2017,46(11):1540-1542.
[5]孙艺红,余金明,胡大一.中国稳定性冠心病患者心率控制与β受体阻滞剂使用状况分析[J].中华心血管病杂志,2016,44(1):19-26.
[6]李丹丹,董蔚,陈韵岱,等.北京24家医院住院冠心病患者静息心率控制及β受体阻滞剂使用状况[J].中华医学杂志,2015,95(28):2272-2276.
[7]孙桂强,张文龙,王文,等.卡维地洛治疗无心梗冠心病患者心绞痛的临床疗效观察[J].重庆医学,2017,46(2):241-243.
[8]Fangauf SV,Herbeck Belnap B,Meyer T,et al.Associations of NT-pro BNP and parameters of mental health in depressed coronary artery disease patients[J].Psychoneuroendocrinology,2018,96:188-194.
[9]Dopp H,Maagh P,Meissner A.Heart Failure Despite Low BNP-Level:Paradoxon or Pathfinder?--A Case of Pericarditis constrictiva[J].Dtsch Med Wochenschr,2018,143(10):731-734.
[10]Gupta A,Beig JR,Tramboo NA,et al.The effect of percutan eous coronary revascularization on plasma N-terminal pro-B-type natriuretic peptide levels in stable coronary artery disease[J].Indian Heart J,2018,70(2):282-288.
[11]杨增荣,龚金龙,吴婷竹,等.6min步行试验对冠心病诊断的价值[J].心血管康复医学杂志,2016,25(6):594-598.
[12]黄玉,杨健,白海鹏,等.老年冠心病再血管化患者运动康复治疗疗效[J].中国循证心血管医学杂志,2016,8(4):480-482.
[13]何文芳,杨新春.NT-pro BNP和6MWT对曲美他嗪治疗慢性心力衰竭的疗效评估及其相关性研究[J].湖南中医药大学学报,2014,34(7):44-46,58.
[14]李平,李佑美.曲美他嗪联合美托洛尔治疗冠心病心力衰竭对血浆BNP影响及疗效观察[J].海南医学院学报,2016,22(2):126-128.
[15]王晓艳,杨侃,孙明,等.脑钠肽及和肽素水平与冠心病患者冠脉病变程度的相关性[J].中国全科医学,2010,13(2):145-147.
[16]Nichols S,Taylor C,Page R,et al.Is Cardiorespiratory Fitness Related to Cardiometabolic Health and All-Cause Mortality Risk in Patients with Coronary Heart Disease?A CARE CR Study[J].Sports Med Open,2018,4(1):22.
[17]袁慧.关注BNP与NT-pro BNP的临床应用[J].中华检验医学杂志,2012,35(10):870-873.
[18]邱宗利.B型脑利钠肽联合心肌酶谱检测在冠心病危险分层和冠脉搭桥术中的预测作用[J].实用医学杂志,2015,31(8):1259-1262.
[19]Sawaguchi T,Nakajima T,Hasegawa T,et al.Serum adiponectin and TNFαconcentrations are closely associated with epicardial adipose tissue fatty acid profiles in patients undergoing cardiovascular surgery[J].Int J Cardiol Heart Vasc,2017,18:86-95.
[20]林勇军,吴春芳,叶志荣,等.超敏C反应蛋白和脑钠肽及脂联素水平与冠心病患者相关性[J].中国临床药理学杂志,2017,33(5):463-466.