摘要
目的观察难治性心力衰竭患者在指南引导药物治疗(GDMT)的基础上加服特拉唑嗪干预后的短期和长期临床疗效。方法筛选符合难治性心力衰竭的患者128例,随机分为试验组和对照组,各64例。所有患者GDMT基础上加服盐酸特拉唑嗪治疗4周,观察短期疗效;1年随访中,试验组死亡4例、退出4例、失访1例,对照组分别为5例、6例和3例。最终试验组55例(GDMT且继续服特拉唑嗪)和对照组50例(GDMT),治疗1年,观察长期疗效。结果与治疗前比较,患者服用4周特拉唑嗪治疗后LVEF明显升高[(29.54±4.75)%vs(27.73±6.54)%,P<0.01],中心静脉压(P<0.01)和NT-proBNP明显减低[(2316.22±899.44)ng/L vs(4766.40±497.40)ng/L,P<0.01]。患者服用1年特拉唑嗪后,与对照组比较,试验组LVEF明显升高[(28.75±4.16)%vs(22.46±3.51)%,P<0.01],N末端B型钠尿肽前体明显降低[(2138.85±669.28)ng/L vs(3526.68±1116.11)ng/L,P<0.01],6min步行距离明显延长[(349.00±23.52)mvs(276.12±103.28)m,P<0.01],再住院次数明显减少[(1.12±1.15)次vs(4.12±1.56)次,P<0.01];肌酐和天冬氨酸转氨酶均明显降低(P<0.01)。结论难治性心力衰竭在GDMT基础上,短期和长期联合应用盐酸特拉唑嗪均有较好的临床疗效,值得推广和应用。
Objective To study the short and long-term effect of GDMT plus terazosin in the treatment of patients with refractory heart failure（RHF）.Methods 105 RHF patients were treated for 4 weeks with GDMT plus terazosin,and the short term effect was recorded.Then they were randomly divided into experimental group（n=55）and control group（n=50）.The patients in experimental group were treated with GDMT plus terazosin while those in control group were treated with GDMT,both for 1 year.The long-term outcomes in two groups were recorded.ResultsThe LVEF level was significantly increased,while the central venous pressure and serum NT-proBNP level were significantly decreased after 4 weeks treatment of GDMT plus terazosin as compared to the baseline（P 0.01）.The LVEF was significantly higher while the serum NT-proBNP level was significantly lower,the 6-min walking distance was much longer,the readmission times were significantly less,the serum creatinine and transaminase levels were significantly lower in experimental group than in control group after 1 year of terazosin treatment（28.75%±4.16% vs 22.46% ±3.51%;2138.85±669.28 ng/L vs 3526.68±1116.11 ng/L;349.00±23.52 mvs 276.12±103.28 m;1.12±1.15 vs 4.12±1.56;65.61±12.92μmol/L vs106.74±60.59μmol/L;35.62±9.01 U/L vs 110.84±55.86 U/L,P〈0.01）.Conclusion The short and long-term effect of GDMT plus terazosin is rather good on RHF,which is worthy of popularization and application in clinical practice.
作者
杨金凤
刘芳
王倩
曹丽羽
郭茂娟
Yang Jinfeng;Liu Fang;Wang Qian;Cao Liyu;Guo Maojuan(Department of Hypertension,Jizhou District People＇s Hospital,Tianjin 301900,China)
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2018年第9期915-918,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
基金
国家自然科学基金(81774071)
天津中医药大学中西医结合学院基金(zxyky201601)
