临床内科杂志 ›› 2020, Vol. 37 ›› Issue (1): 32-35.doi: 10.3969/j.issn.1001-9057.2020.01.010

• 论 著 • 上一篇    下一篇

卡维地洛联合丹参酮ⅡA磺酸钠对慢性心力衰竭患者心室重构及能量代谢的影响

  

  • 出版日期:2020-01-15 发布日期:2020-01-15
  • 基金资助:
    河北省重点研发计划项目(182777188)

Effect of carvedilol combined with TanshinoneⅡA sulfonate sodium on ventricular remodeling and energe metabolism in patients with chronic heart failure

  • Online:2020-01-15 Published:2020-01-15

摘要: 目的 探讨卡维地洛联合丹参酮ⅡA磺酸钠对慢性心力衰竭(CHF)患者心室重构及能量代谢的影响。方法 将226例CHF患者随机分为对照组114例和观察组112例,两组患者均接受常规抗心力衰竭药物和卡维地洛治疗,观察组患者在此基础上加用丹参酮ⅡA磺酸钠,治疗8周后,比较两组患者的心功能[左心室舒张末期内径(LVEDd)、左心室收缩末期内径(LVESd)、左心室射血分数(LVEF)]、心室重构指标[左心室厚壁厚度(LVPET)、左心室内径缩短率(LVFS)、室间隔收缩末期厚度(IVSS)、左心室质量指数(LVMI)]、能量代谢指标[左心室收缩末周向室壁应力(cESS)、心肌能量消耗(MEE)]、心肌酶谱[肌酸激酶(CK)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)]及血流动力学指标[心脏指数(CI)、每搏输出量(SV)、肺毛细血管楔压(PCWP)]。结果治疗后两组患者LVEDd、LVESd、LVPWT、IVSS、LVMI、cESS、MEE、CK、CK-MB、LDH、CI、SV及PCWP均低于同组治疗前,LVEF和LVFS均高于同组治疗前(P<0.05)。治疗后观察组患者LVEDd、LVESd、LVPWT、IVSS、LVMI、cESS、MEE、CK、CK-MB、LDH、CI、SV及PCWP均低于对照组,LVEF和LVFS均高于对照组(P<0.001或P<0.05)。结论 卡维地洛联合丹参酮ⅡA磺酸钠治疗可改善CHF患者的心肌酶谱和血流动力学,抑制心室重构和能量代谢进程,从而改善其心功能。

关键词: 卡维地洛; 丹参酮ⅡA磺酸钠; 慢性心力衰竭; 心室重构; 能量代谢

Abstract: Objective To observe the effect of carvedilol combined with Tanshinone ⅡA sulfonate sodium on ventricular remodeling and energe metabolism in patients with chronic heart failure(CHF).Methods A total of 226 patients with CHF were randomly divided into control group(114 cases) and observation group(112 cases).Patients in the two groups received conventional anti-heart failure drugs and carvedilol.Patients in observation group were added sodium tanshinone ⅡA sulfonate on basis of above treatment.After 8 weeks of treatment,cardiac function[left ventricular end diastolic dimension(LVEDd),left ventricular endsystolic dimension(LVESd),left ventricular ejection fraction(LVEF)],ventricular remodeling indexes[left ventricular posterior wall thickness(LVPWT),left ventricular fraction shortening(LVFS),inter ventricular spetal end systolic thickness(IVSS),left ventricular mass index(LVMI)],energe metabolism indexes[circumferential end systolic wall stress(cESS),myocardial energy expenditure(MEE)],myocardial enzyme profile[creatine kinase(CK),creatine kinase isoenzyme(CK-MB),lactate dehydrogenase(LDH)] and hemorheology indexes[pulmonary capillary wedge pressure(PCWP),cardiac index(CI),stroke volume(SV)] were compared between the two groups.Results LVEDd,LVESd,LVPWT,IVSS,LVMI,cESS,MEE,CK,CK-MB,LDH,CI,SV and PCWPC after treatment were all significantly lower than those before treatment in the two groups,while LVEF and LVFS were significantly higher than those before treatment in the two groups(P<0.05).After treatment,LVEDd,LVESd,LVPWT,IVSS,LVMI,cESS,MEE,CK,CK-MB,LDH,CI,SV and PCWPC in observation group were all significantly lower than those in control group,while LVEF and LVFS were significantly higher than those in control group(P<0.001 or P<0.05).Conclusion Carvedilol combined with Tanshinone ⅡA sulfonate sodium can improve myocardial enzyme profile and hemorheology,suppress ventricular remodeling and energe metabolism,so as to improve cardiac function in patients with CHF.

Key words: Carvedilol;Tanshinone ⅡA sulfonate sodium;Chronic heart failure; Ventricular remodeling;Energe metabolism