摘要
目的 探讨慢性心力衰竭患者应用环磷腺苷葡胺与培哚普利联合治疗的临床价值。方法 105例慢性心力衰竭患者,按照随机数字表法分为对照组、培哚普利组及联合组,每组35例。对照组行常规抗心力衰竭药物治疗,培哚普利组在对照组治疗基础上加用培哚普利吲达帕胺片治疗,联合组在培哚普利组治疗基础上行环磷腺苷葡胺治疗。观察三组治疗效果、心输出量(CO)水平、左心室射血分数(LVEF)水平、氨基末端B型利钠肽前体(NT-proBNP)水平、丙二醛(MDA)水平、超氧化物歧化酶(SOD)水平。结果 治疗后,联合组CO、LVEF水平分别为(4.91±0.84)L/min、(48.37±3.05)%,培哚普利组分别为(4.09±1.02)L/min、(44.69±3.37)%,对照组分别为(3.27±1.02)L/min、(39.51±3.56)%。治疗后,三组CO、LVEF水平均明显高于本组治疗前,且三组CO、LVEF水平比较差异有统计学意义(P<0.05)。联合组CO、LVEF水平明显高于对照组、培哚普利组,培哚普利组CO、LVEF水平明显高于对照组,差异有统计学意义(P<0.05)。治疗后,联合组NT-proBNP水平为(946.37±279.16)pg/ml,培哚普利组为(1091.74±288.87)pg/ml,对照组为(1523.83±406.07)pg/ml。治疗后,三组NT-proBNP水平均明显低于本组治疗前,且三组NT-proBNP水平比较差异有统计学意义(P<0.05),联合组NT-proBNP水平明显低于对照组、培哚普利组,培哚普利组NT-proBNP水平低于对照组,差异有统计学意义(P<0.05)。治疗后,联合组MDA、SOD水平分别为(4.21±0.82)μmol/L、(90.41±8.45)U/L,培哚普利组分别为(5.39±0.71)μmol/L、(82.68±8.37)U/L,对照组分别为(6.01±0.67)μmol/L、(75.53±8.56)U/L。治疗后,三组MDA水平低于本组治疗前、SOD水平高于本组治疗前,且三组MDA、SOD水平比较差异有统计学意义(P<0.05)。联合组MDA水平低于对照组、培哚普利组,培哚普利组MDA水平低于对照组,差异有统计学意义(P<0.05);联合组SOD水平高于对照组、培哚普利组,培哚普利组SOD水平高于对照组,差异有统计学意义(P<0.05)。联合组治疗总有效率为94.29%,培哚普利组为74.29%,对照组为65.71%。联合组治疗总有效率明显高于对照组、培哚普利组,差异有统计学意义(P<0.05)。结论 慢性心力衰竭患者采用环磷腺苷葡胺与培哚普利吲达帕胺片联合治疗效果明显,能调节患者心功能,改善氧化应激反应,具有较高的临床价值。
Objective To discuss the clinical value of meglumine adenosine cyclphosphate combined with perindopril in the treatment of chronic heart failure. Methods A total of 105 patients with chronic heart failure were divided into the control group, the perindopril group and the combination group according to the random numerical table, with 35 patients in each group. The control group was treated with conventional antiheart failure drugs, the perindopril group was treated with perindopril indapamide tablets on the basis of the control group, and the combination group was treated with meglumine adenosine cyclphosphate on the basis of the perindopril group. Observation was made on therapeutic effect, cardiac output(CO) level, left ventricular ejection fraction(LVEF) level, N-terminal pro-B-type natriuretic peptide(NT-proBNP) level, malondialdehyde(MDA) level, and superoxide dismutase(SOD) level in the three groups. Results After treatment, the CO and LVEF levels were(4.91±0.84) L/min and(48.37±3.05)% in the combination group,(4.09±1.02) L/min and(44.69±3.37)% in the perindopril group, and(3.27±1.02) L/min and(39.51±3.56)% in the control group. After treatment, the CO and LVEF levels in all three groups were significantly higher than those before treatment in this group, and the difference in CO and LVEF levels among the three groups was statistically significant(P<0.05).The CO and LVEF levels in the combination group were significantly higher than those in the control group and perindopril group, and the CO and LVEF levels in the perindopril group were significantly higher than those in the control group. The differences were statistically significant(P<0.05). After treatment, the NT-proBNP level was(946.37±279.16) pg/ml in the combination group,(1091.74±288.87) pg/ml in the perindopril group, and(1523.83±406.07) pg/ml in the control group. After treatment, the NT-proBNP levels in all three groups were significantly lower than those before treatment in this group, and the difference in NT-proBNP levels in the three groups was statistically significant(P<0.05). The NT-proBNP level in the combination group were significantly lower than that in the control group and perindopril group, and NT-proBNP level in the perindopril group was lower than that in the control group, and the differences were statistically significant(P<0.05). After treatment,the MDA and SOD levels were(4.21±0.82) μmol/L and(90.41±8.45) U/L in the combination group,(5.39±0.71) μmol/L and(82.68±8.37) U/L in the perindopril group, and(6.01±0.67) μmol/L and(75.53±8.56) U/L in the control group. After treatment, the MDA levels in the three groups were lower those before treatment in this group, and the SOD levels were higher than those before treatment in this group;the differences in the MDA and SOD levels in the three groups were statistically significant(P<0.05). The MDA level in the combination group were lower than that in the control group and perindopril group, and MDA level in the perindopril group was lower than that in the control group, and the differences were statistically significant(P<0.05). The SOD level in the combination group was higher than that in the control group and the perindopril group, and the SOD level in the perindopril group was higher than that in the control group, and the difference was statistically significant(P<0.05).The total effective rate of treatment was 94.29% in the combination group, 74.29% in the perindopril group, and 65.71% in the control group. The total effective rate of treatment in the combination group was significantly higher than that in the control group and perindopril group, and the difference was statistically significant(P<0.05).Conclusion The combination of meglumine adenosine cyclphosphate and perindopril indapamide tablets can significantly improve the therapeutic effect of patients with chronic heart failure, regulate cardiac function and improve oxidative stress response, which contains high clinical value.
作者
李东学
LI Dong-xue(Shenyang Coal General Hospital of Liaoning Health Industry Group,Shenyang 110122,China)
出处
《中国现代药物应用》
2023年第3期19-22,共4页
Chinese Journal of Modern Drug Application
