摘要
目的探讨糖皮质激素辅助厄贝沙坦氢氯噻嗪治疗重症心力衰竭的临床效果。方法选取2016年1月~2017年7月我院收治的50例重症心力衰竭患者作为研究对象,按照随机数字法将其平均分为对照组和研究组,每组各25例。对照组患者予以厄贝沙坦氢氯噻嗪治疗,研究组患者予以糖皮质激素联合厄贝沙坦氢氯噻嗪治疗。比较两组患者的临床疗效、超声心动图检查结果、神经内分泌因子变化情况以及6 min步行试验距离。结果研究组患者的临床治疗总有效率(92.00%)显著高于对照组(70.00%),差异有统计学意义(P<0.05)。干预后,两组患者的LVIDD、LVISD、LVEDV、LVESV均显著低于本组干预前,LVEF显著高于本组干预前,差异有统计学意义(P<0.05);研究组患者的LVIDD、LVISD、LVEDV、LVESV均显著低于对照组,LVEF显著高于对照组,差异有统计学意义(P<0.05)。干预后,两组患者的ALD、COR、ET、TGF-Β1、Hs-CRP比较,差异有统计学意义(P<0.05),两组患者的ANP、Β2-MG比较,差异无统计学意义(P>0.05)。干预后,两组患者的6 min步行试验距离均显著高于本组干预前,且研究组显著高于对照组,差异均有统计学意义(P<0.05)。结论糖皮质激素辅助厄贝沙坦氢氯噻嗪治疗重症心力衰竭,可以改善神经内分泌因子分泌及心功能,提高临床疗效。
Objective To investigate the clinical efficacy of glucocorticoids in the treatment of severe heart failure with Irbesartan and Hydrochlorothiazide.Methods 50 patients with severe heart failure treated in our hospital from January 2016 to July 2017 were selected as subjects and randomly divided into control group and study group according to ran- dom number method,25 cases in each group.The patients in the control group were treated with Irbesartan and Hy- drochlorothiazide,and patients in the the study group were treated with glucocorticoids combined with Irbesartan and hydrochlorothiazide.The clinical efficacy,echocardiographic findings,changes of neuroendocrine factors and the distance of 6 min walk test were compared between the two groups.Results The total effective rate of the study group （92.00%） was significantly higher than that of the control group （70.00%）,and the difference was statistically significant （P〈0.05）. After the intervention,two groups of LVISD,LVIDD,LVEDV and LVESV both were significantly lower than before the intervention,LVEF was significantly higher than before the intervention,and the differences were statistically significant （P〈O.O5）.The LVISD,LVIDD,LVEDV and LVESV in the study group were significantly lower than those in the control group, LVEF was significantly higher than that in the control group,and the differences were statistically significant （P〈0.05）. After the intervention,two groups of ALD,COR,ET,TGF-B1 and Hs-CRP both were compared,and the differences were statistically significant （P〈0.05）,while the ANP and B2-MG were compared,the differenced were not statistically signifi- cant （P〉0.05）.After the intervention,the distance of 6 min walking test in the study group was significantly higher than that in the control group,and the difference was statistically significant （P〈0.05）.Conclusion Glucocorticoid-assisted Irbesartan and Hydrochlorothiazide in the treatment of severe heart failure can improve neuroendocrine factor secretion and cardiac function and imoroves clinical efficacy.
出处
《中国当代医药》
2018年第1期135-138,共4页
China Modern Medicine
