郭浩,闫娜,王营忠,宋延彬
GUO Hao,YAN Na,WANG Yingzhong,SONG Yanbin

• 1:延安大学附属医院心内科

摘要(Abstract)：

目的:探讨左西孟旦注射液联合比索洛尔对老年慢性心力衰竭(CHF)患者血清心肌肌钙蛋白(cTNT)及类胰岛素增长因子(IGF-1)水平的影响。方法:78例老年CHF患者随机分为对照组及联合治疗组,对照组采用比索洛尔治疗,联合治疗组采用比索洛尔联合左西孟旦治疗,2周为1疗程;于治疗前及治疗1个疗程时,检查2组患者左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)及左心室射血分数(LVEF),测定血清中cTNT、IGF-1、脂质过氧化物酶(LPO)、血清丙二醛(MDA)、总抗氧化态(TAS)、C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)及白细胞介素-6(IL-6)水平。结果:治疗前,2组患者LVEDD、LVESD、LVEF及血清cTNT、IGF-1、TAS、MDA、LPO、CRP、TNF-α、IL-6水平比较,差异无统计学意义(P>0.05);治疗后,2组患者LVEDD、LVESD及血清cTNT、MDA、LPO、CRP、TNF-α、IL-6水平较治疗前显著降低,联合治疗组更明显,差异有统计学意义(P<0.05);治疗后,2组患者LVEF及血清ICF-1、TAS水平较治疗前显著升高,联合治疗组更明显,差异有统计学意义(P<0.05)。结论:左西孟旦注射液联合比索洛尔能够有效的改善老年CHF患者的心脏功能,其机制可能与cTNT水平降低及ICF-1水平升高有关。
Objective: To investigate the effect of levosimendan injection combined with bisoprolol on serum levels of cardiac troponin(cTnT) and insulin-like growth factors(IGF-1) in elderly patients with chronic heart failure(CHF). Methods: 78 cases of elderly patients with CHF were randomly divided into the control group(treated with bisoprolol) and combined treatment group(treated with bisoprolol and levosimendan), with a course of treatment of 2 weeks. Before and after one course of treat, examine the 2 groups of patients with left ventricular end-diastolic diameter(LVEDD), left ventricular end-systolic diameter(LVESD) and left ventricular ejection fraction(LVEF), the determination of levels with serum cTnT, IGF-1, lipid peroxidase(LPO), malondialdehyde(MDA), total antioxidant status(TAS), C-creactive protein(CRP), tumor necrosis factor-α(TNF-α)and interleukin-6(IL-6). Results: Before treatment, the levels of LVEDD, LVESD, LVEF and serum cTnT, IGF-1,TAS, MDA, LPO, CRP, TNF-α and IL-6 were compared between two groups. The difference was not statically significant(P<0.05). After treatment, the levels of LVEDD, LVESD, LVEF and serum cTnT, IGF-1,TAS, MDA, LPO, CRP, TNF-α and IL-6 in two groups were significantly lower than that before treatment, which was more significantly in the combined treatment group. The difference was statistically significant(P<0.05). The levels of LVEF, serum ICF-1 and TAS in two groups were significantly higher than that before treatment, which was more significantly in the combined treatment group. The difference was statistically significant(P<0.05). Conclusion: The levosimendan injection combined with bisoprolol can effectively improve cardiac function in elderly CHF patients, and the mechanism may be related to decreased cTnT level and increased ICF-1 level.

关键词(KeyWords)： 慢性心力衰竭;老年患者;左西孟旦;比索洛尔;心肌肌钙蛋白;类胰岛素增长因子;心脏功能;氧化应激;炎性因子
chronic heart failure;elderly patients;levosimendan;bisoprolol;cardiac troponin;insulin-like growth factor;cardiac function;oxidative stress;inflammatory factor

Abstract:

Keywords:

基金项目(Foundation): 陕西省重点研发计划(Grant No.2018SF-116)

作者(Author): 郭浩,闫娜,王营忠,宋延彬
GUO Hao,YAN Na,WANG Yingzhong,SONG Yanbin

DOI: 10.19367/j.cnki.1000-2707.2019.10.022

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