比索洛尔联合曲美他嗪对慢性心力衰竭患者心功能康复的影响

摘要

Objective:To explore the effect of bisoprolol in combined with trimetazidine on the cardiac function rehabili-tation in patients with chronic heart failure (CHF).Methods:A total of 84 patients with CHF who were admitted in our hospi-tal from November,2015 to October,2016 were included in the study and randomized into the observation group and the con-trol group.The patients in the two groups were given oxygen inhalation,lipid regulation,diuresis,ARB,and other routine treatments.Digitalis preparations were given for those who had poor cardiac function,and bisoprolol were orally administrated in the same time.On the above basis,the patients in the observation group were given trimetazidine dihydrochloride tablets, continuously for 3 months.The morning fasting peripheral venous blood before and after treatment in the two groups was col-lected.CRP,IL-6,TNF-α,BNP,NE,AngⅡ,ANP,ALD,and ET were detected.The cardiac color Doppler ultrasound di-agnostic apparatus was used to detect LVPWT,PWS,PWD,IVSS,and IVMI.Results:CRP,IL-6,TNF-α,and BNP levels after treatment in the observation group were significantly lower than those in the control group (P < 0.05 ).NE,Ang Ⅱ, ANP,ALD,and ET levels after treatment in the observation group were significantly lower than those in the control group (P<0.05).LVPWT,PWS,PWD,IVSS,and IVMI levels after treatment in the observation group were significantly lower than those in the control group (P <0.05).Conclusions:Bisoprolol in combined with trimetazidine can significantly reduce the in-flammatory reaction in patients with CHF,and effectively regulate the neuroendocrine stability in order to reverse or reduce VR and improve the left ventricular function.%目的:探讨比索洛尔联合曲美他嗪对慢性心力衰竭(CHF)患者心功能康复的影响.方法:选取本院收治的CHF患者84例进行研究,随机分为观察组和对照组,2组均给予吸氧、调脂、利尿、血管紧张素受体阻滞剂等常规治疗,心功能不佳者可加服洋地黄制剂,同时口服比索洛尔;观察组在上述治疗的基础上口服盐酸曲美他嗪片,2组连服3个月.治疗前后抽取清晨空腹外周静脉血,分别测定C反应蛋白(CRP)、白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、脑利钠肽(BNP)、去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)、心钠素(ANP)、醛固酮(ALD)、内皮素(ET),心脏彩色多普勒超声诊断仪测定左心室后壁厚度(LVPWT)、左心室后壁收缩末期厚度(PWS)、左心室后壁舒张末期厚度(PWD)、室间隔收缩末期厚度(IVSS),并计算左室心肌质量指数(IVMI).结果:观察组治疗后CRP、IL-6、TNF-α、BNP低于对照组(P<0.05),观察组治疗后NE、AngⅡ、ANP、ALD、ET低于对照组(P<0.05),观察组治疗后LVPWT、PWS、PWD、IVSS、IVMI低于对照组(P<0.05).结论:比索洛尔联合曲美他嗪可明显降低CHF患者炎性反应,有效调节神经内分泌稳定,从而逆转或减少VR,改善左心室功能.