左西孟旦治疗慢性心力衰竭患者疗效及其对cTNT和IGF-1等细胞因子水平的影响

摘要

目的 观察左西孟旦治疗慢性心力衰竭患者疗效及其对心肌肌钙蛋白T(cTNT)和类胰岛素生长因子-1(IGF-1)水平等的影响.方法 选择2014年6月—2016年6月辽宁省金秋医院综合老年医学科二病房收治的慢性心力衰竭患者114例作为研究对象,按照抽签法随机分为对照组和观察组,每组57例.对照组予以常规治疗,观察组在对照组基础上联合左西孟旦治疗,治疗3 d后比较2组cTNT和CF-1水平、N末端脑钠肽前体(NT-proBNP)、炎性因子及氧化应激水平,以及血流动力学及心功能指标,并观察其安全性.结果 治疗后,观察组cTNT低于对照组[(66 S.39±15.32)ng/L vs.(77.83±18.20)ng/L,t=3.630,P=0.000],IGF-1高于对照组[(138.60±18.240)μg/L vs.(121.46±15.32)μg/L,t=5.432,P=0.000];观察组NT-proBNP低于对照组[(4049.87±452.30)ng/L vs.(4276.94±483.96)ng/L,t=2.588,P=0.000];观察组炎性因子及氧化应激水平改善更明显(P<0.05),血流动力学指标优于对照组(P<0.05).2组左室收缩末期内径、左室舒张末期内径比较差异无统计学意义(P>0.05),而左室射血分数较治疗前均升高(P<0.05);2组均未见严重不良反应.结论 慢性心力衰竭患者应用左西孟旦治疗后能够降低cTNT及IGF-1水平.%Objective To The curative effect of levosimendan in patients with chronic heart failure and the influences on Cardiac troponin T(cTNT) andInsulin-like growth factor-1((IGF-1) and other cytokines level.Methods 114 cases of pa-tients with chronic heart failure from June 2014 to June 2014 were treated , wich from Liaoning Jinqiu Hospital geriatric medi-cine two wards,according to the draw method divided into control group and the observation group , each have 57 cases, control group routine therapy, the observation group based on control group joint leosimendan , two groups' of cTNT and ICF-1 level, N terminal brain natriuretic peptide precursor ( NT-proBNP ) , inflammatory factor and oxidative stress levels , hemodynamics and cardiac function index, safety were compared.Results After treatmented, the cTNT (66.39 ±15.32) ng/L of observa-tion group was lower than the control group (77.83 ±18.20) ng/L, the IGF-1 (138.60 ±18.240) μg/L of observation group was higher than the control group (121.46 ±15.32) μg/L, the difference was statistically significant ( t =3.630、5.432, P =0.000,0.000).The NT-proBNP (4049.87 ±452.30 ) ng/L of observation group was lower than the control group (4276.94 ±483.96) ng/L, the difference was statistically significant ( t =2.588, P =0.000).The inflammatory factor and oxidative stress level of observation group was improved more significantly ( P <0.05).The hemodynamic index of obser-vation group was better than the control group ( P <0.05).The cardiac function index of two groups was no statistical differ-ence ( P >0.05).The security of two groups was no statistical difference ( P >0.05).Conclusion Levosimendan in treat-ment of chronic heart failure can reduce the level of cTNT and IGF-1.