环磷腺苷葡胺联合雷米普利治疗老年慢性心力衰竭的疗效及其对患者血清hs-CRP的影响

Effect of meglumine adenosine cyclophosphate combined with ramipril on serum hs-CRP in patients with chronic heart failure

目的探讨环磷腺苷葡胺联合雷米普利治疗老年慢性心力衰竭(CHF)的疗效及其对患者血清超敏C反应蛋白(hs-CRP)的影响。方法选取东莞市樟木头医院2015年6月至2017年8月收治的90例老年CHF患者,采用随机分层法分为对照组和观察组,每组45例,对照组在常规治疗的基础上应用雷米普利,观察组在对照组基础上应用环磷腺苷葡胺,疗程为2周,比较两组治疗前后的心功能指标、血清hs-CRP水平及临床疗效。结果观察组患者治疗后的左室射血分数(LVEF)、二尖瓣血流E峰最大流速/A峰最大流速(E/A)、左室舒张末期内径(LVD)、左室收缩末期内径(LVS)分别为(48.58±4.68)%、(1.26±0.13)、(46.29±4.05) mm、(25.09±3.01) mm,对照组患者则分别为(42.28±4.53)%、(1.12±0.11)、(53.57±4.93) mm、(31.69±3.05) mm,两组比较差异均有统计学意义(P<0.05);观察组治疗后的血清hs-CRP水平为(2.53±1.33) mg/mL,明显低于对照组的(4.29±1.31) mg/mL,差异有统计学意义(P<0.05);观察组患者的临床治疗总有效率为93.33%,明显高于对照组的77.78%,差异有统计学意义(P<0.05)。结论环磷腺苷葡胺联合雷米普利治疗老年CHF可有效改善患者的左心室功能,延缓心室重构进展,其作用可能与下调血清hs-CRP因子有关,是治疗老年CHF的良好方案。

Objective To explore the effect of meglumine adenosine cyclophosphate(McAMP) combined with ramipril in the elderly patients with chronic heart failure(CHF) and the effect on serum hypersensitive C-reactive protein(hs-CRP). Methods From August 2017 to June 2015, 90 elderly CHF patients treated in Dongguan City Zhangmutou People’s Hospital were divided into the control group(n=45) and observation group(n=45). Patients in the control group were treated with ramipril on the basis of routine treatment, and those in the observation group were treated with McAMP on the basis of the control group, all for 2 weeks. The cardiac function indexes, serum hs-CRP level, and clinical efficacy were compared between the two groups before and after treatment. Results The left ventricular ejection fraction(LVEF), maximum flow rate of E peak at mitral valve peak flow peak velocity(E/A), left ventricular end diastolic diameter(LVD), and left ventricular end systolic diameter(LVS) were(48.58±4.68)%, 1.26±0.13,(46.29±4.05) mm,(25.09±3.01) mm, respectively, versus(42.28±4.53)%, 1.12±0.11,(53.57±4.93) mm,(31.69±3.05) mm in the control group(P<0.05). The serum hs-CRP level in the observation group was(2.53±1.33) mg/mL after treatment, which was significantly lower than(4.29 ± 1.31) mg/mL in the control group(P<0.05). The total effective rate of the observation group(93.33%) was significantly higher than that of the control group(77.78%), and the difference was statistically significant(P<0.05). Conclusion McAMP and ramipril can effectively improve the left ventricular function and delay the progress of ventricular remodeling in patients with CHF, which may be related to the down-regulation of serum hs-CRP.It is a good scheme for the treatment of CHF in the elderly.