摘要
目的探讨厄贝沙坦联合多巴酚丁胺对冠心病心力衰竭患者的治疗效果。方法选取2018年4月~2019年4月在我院接受治疗的124例冠心病心力衰竭患者为研究对象,随机分为多巴酚丁胺组与联合治疗组,每组62例。多巴酚丁胺组患者使用多巴酚丁胺进行治疗,联合治疗组患者使用厄贝沙坦联合多巴酚丁胺进行治疗。评价两组患者的心功能,酶联免疫吸附实验法检测肿瘤坏死因子-α(TNF-α)水平、白细胞介素-1β(IL-1β)、白细胞介素-6(IL-6)、谷胱甘肽过氧化物酶(GSH-Px)、过氧化脂(LPO)及丙二醛(MDA)水平,流式细胞仪检测T淋巴细胞亚群水平,免疫透射比浊法检测骨保护素(OPG)、胰岛素样生长因子1(IGF-1)水平,对比两组治疗效果及不良反应。结果治疗后,联合治疗组患者左室后壁厚度(LVPWd)水平低于多巴酚丁胺组,左室射血分数(LVEF)、每搏心输出量(SV)水平高于多巴酚丁胺组(均P<0.05)。治疗后,联合治疗组TNF-α、IL-1β、IL-6、LPO、MDA、CD8+及OPG水平低于多巴酚丁胺组,GSH-Px、CD4+、CD3+、IGF-1水平高于多巴酚丁胺组(均P<0.05)。联合治疗组治疗总有效率高于多巴酚丁胺组(P<0.05)。联合治疗组不良反应发生率略高于多巴酚丁胺组,但差异无统计学意义(P>0.05)。结论厄贝沙坦联合多巴酚丁胺治疗冠心病心力衰竭患者,能够提升患者心功能及免疫功能,减轻炎症反应及氧化应激损伤严重程度,调控OPG、IGF-1水平,治疗效果好且具有一定安全性。
Objective To explore the therapeutic effect of irbesartan combined with dobutamine in patients with coronary heart disease(CHD)and heart failure(HF).Methods 124 patients with CHD and HF treated in our hospital from April 2018 to April 2019 were randomly divided into dobutamine group(62 cases)and combined treatment group(62 cases).Dobutamine group was treated with dobutamine,and irbesartan combined with dobutamine was used in the combined treatment group.The cardiac function of the two groups was evaluated.The levels of tumor necrosis factor-α(TNF-α),interleukin-1β(IL-1β),interleukin-6(IL-6),glutathione peroxidase(GSH-Px),lipid peroxide(LPO),malondialdehyde(MDA)were detected by enzyme-linked immunosorbent assay,and the levels of T lymphocyte subsets were detected by immunotransmission turbidimetry.The levels of protective hormone(OPG)and insulin-like growth factor 1(IGF-1)were compared between the two groups.Results After treatment,the left ventricular posterior wall thickness(LVPWd)level in the combined treatment group was lower than that in the dobutamine group,and the levels of left ventricular ejection fraction(LVEF)and stroke cardiac output(SV)were higher than those in the dobutamine group(P<0.05).After treatment,the levels of TNF-α,IL-1β,IL-6,LPO,MDA,CD8+,OPG in the combined treatment group were lower than those in the dobutamine group(P<0.05).After treatment,the levels of GSH-Px,CD4+,CD3+,IGF-1 in the combined treatment group were higher than those in the dobutamine group(P<0.05).The total effective rate in the combined treatment group was higher than that in the dobutamine group(P<0.05).The incidence of adverse reactions in the combined treatment group was slightly higher than that in the dobutamine group,but there was no statistical difference(P>0.05).Conclusion Irbesartan combined with dobutamine can improve the cardiac function and immune function of patients with CHD and heart failure,reduce the severity of inflammation and oxidative stress injury,regulate the levels of OPG and IGF-1,and have significant therapeutic effect and certain safety.
作者
唐燕
郭文龙
汤新颜
莫柞群
TANG Yan;GUO Wenlong;TANG Xinyan;MO Zuoqun(ICU,The First Affiliated Hospital of Hunan Traditional Chinese Medical College,Zhuzhou 412000,Hunan,China)
出处
《西部医学》
2020年第12期1789-1793,共5页
Medical Journal of West China
基金
湖南省卫健委科研项目(C2019012)。
关键词
厄贝沙坦
多巴酚丁胺
冠心病心力衰竭
心功能
Irbesartan
Dobutamine
Heart failure of coronary heart disease
Cardiac function
