摘要
目的探讨内蒙古高寒地区舒张性心衰的流行病学及临床治疗研究。方法选取500例心衰患者作为研究对象,观察舒张性心衰患者占所有心衰患者比例并观察其性别分布情况,对患者氨基末端脑钠肽前体(NT-proBNP)进行测定,并进行比较,同时将285例舒张性心衰患者随机分为三组,均采用控制血压、降低心室率和利尿等相同的基础治疗,95例患者联合静点硝酸甘油作为硝酸甘油组,95例患者联合静点硝普钠作为硝普钠组,95例患者联合静点苦碟子作为苦碟子组,观察三组患者治疗效果及NT-proBNP的变化。结果 285例舒张性心衰患者,占所有心衰患者的57.00%,其中女性舒张性心衰患者占所有女性心衰患者的68.84%(148/215),男性舒张性心衰患者占所有男性心衰患者的48.07%(137/285),性别方面比较,差异有统计学意义(χ2=21.56,P<0.05)。285例舒张性心衰患者NT-proBNP明显高于非舒张性心衰患者,硝酸甘油组治疗总有效率(89.48%)明显高于硝普钠组(67.38%)和苦碟子组(73.69%),且三组患者较治疗前NT-proBNP均显著降低,但硝酸甘油组患者NT-proBNP明显低于其他两组患者,线性回归分析结果显示,舒张性心衰患者心衰程度与NT-proBNP升高表现明显一致(r=1.203,P<0.05)。结论舒张性心衰患者占所有心衰患者较大一部分,且女性患者发病率明显高于男性患者,NT-proBNP与患者心衰程度明显相关,采用硝酸甘油可明显降低NT-proBNP,改善患者心衰程度,提高患者生活质量。
Objective To investigate the epidemiology and clinical treatment of diastolic heart failure in the alpine region of Inner Mongolia.Methods 500 patients with heart failure were selected as the research subjects.The proportion of patients with diastolic heart failure to all the patients with heart failure and the sex distribution were observed.The N-termi-nal pro-brain natriuretic peptide（NT-proBNP） of the patients was measured and compared.285 patients with diastolic heart failure were randomly divided into three groups,of which all received blood pressure control,ventricular rate reduction,diuresis and other similar basic treatment.95 patients receiving combined infusion of Nitroglycerin were assigned to the Nitroglycerin group.95 patients receiving combined infusion of Sodium Nitroprusside were assigned to the Sodium Ni-troprusside group.95 patients receiving combined infusion of Ixeris Sonchifolia Hance were assigned to the Ixeris Sonchifolia Hance group.The treatment effects and NT-proBNP changes of the three groups were observed.Results 285 patients had diastolic heart failure,accounting for 57.00% of all patients with heart failure.Female patients with diastolic heart failure accounted for 68.84%（148/215） of all female patients with heart failure while male patients with diastolic heart failure accounted for 48.07%（137/285） of all male patients with heart failure,with significant sex differences（χ2=21.56,P0.05）.The NT-proBNP of 285 patients with diastolic heart failure was significantly higher than that of patients with non-diastolic heart failure.The total effective rate of the Nitroglycerin group（89.48%） was significantly higher than that of the Sodium Nitroprusside group（67.38%） or the Ixeris Sonchifolia Hance group（73.69%）.The NT-proBNP of the three groups significantly reduced compared with that before the treatment,but the NT-proBNP of the Nitroglycerin group was significantly lower than that of the other two groups.Linear regression analysis showed that the degree of heart failure was consistent with the elevation of NT-proBNP（r=1.203,P0.05）.Conclusion The patients with diastolic heart failure accounts for a major proportion of all patients with heart failure and the incidence of female patients is higher than that of male patients.NT-proBNP is obviously correlated to the degree of heart failure,so Nitroglycerin can significantly reduce NT-proBNP,thus improving the patients＇ degree of heart failure and their quality of life.
出处
《中国医药导报》
CAS
2012年第29期65-67,共3页
China Medical Herald
基金
内蒙古自治区科技计划项目(20100502)
