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

The curative effect of levosimendan in patients with chronic heart failure and the influences on cTNT,IGF-1 and other cytokines level

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[(66.39±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[(4 049.87±452.30)ng/L vs.(4 276.94±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 eTNT and ICF-1 level, N terminal brain natriuretic peptide precursor （NT-proBNP） , inflammatory factor aud 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 （4 049.87±452.30 ） ng/L of observation group was lower than the control group （4 276.94±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.