环磷腺苷葡胺联合培哚普利在慢性心力衰竭中的应用研究

Application Research of Meglumine Cyclic Adenylate and Perindopril in Patients with Chronic Congestive Heart Failure

目的:分析环磷腺苷葡胺联合培哚普利在慢性心力衰竭患者的应用价值。方法:以2013年1月至2015年12月新疆医科大学第五附属医院心血管内科诊治的慢性心力衰竭患者90例为研究对象,将其按照就诊病历顺序号分对照组、培哚普利组和联合组,每组30例。对照组患者接受常规治疗,培哚普利组患者在对照组的基础之上加用培哚普利,联合组患者在培哚普利组的基础之上加用环磷腺苷葡胺,三组患者均连续治疗2周,比较三组临床疗效及治疗前后患者的左心室重塑情况(左心室收缩末期内径(LVESD)和舒张末期内径(LVEDD))及左心室心功能(左心室射血分数(LVEF)),患者活动能力(6 min的步行距离)以及血浆脑钠利肽(BNP)、胰岛素样生长因子1(IGF-1)、胱抑素(Cys-C)水平。结果:经过2周的治疗,培哚普利组和联合组的治疗总有效率分别为86.67%和96.67%,均显著高于对照组的66.67%(P<0.05),但培哚普利组和联合组比较差异无统计学意义(P>0.05);三组患者的LVEDD、LVESD、血浆BNP水平均较治疗前显著降低,且培哚普利组和联合组均显著低于对照组(P<0.05),联合组LVESD、血浆BNP水平显著低于培哚普利组;三组患者的LVEF和6 min步行距离、血浆IGF-1水平均较治疗前显著升高,且培哚普利组和联合组均显著高于对照组,联合组血浆IGF-1水平、LVEF和6 min步行距离显著高于培哚普利组(P<0.05);联合组和培哚普利组治疗后的Cys-C水平治疗前显著降低,且联合组和培哚普利组显著低于对照组,联合组血Cys-C水平较培哚普利组更低(P<0.05)。结论:环磷腺苷葡胺联合培哚普利治疗慢性心力衰竭临床疗效显著,可较单药治疗显著改善患者左心室重构情况、心室射血功能和活动能力,可能与协同调节患者血浆BNP、IGF-1、Cys-C水平有关。

Objective：To investigatethe application value of meglumine cyclic adenylate and perindopril in patients with chronic congestive heart failure（CCHF）.Methods：90 cases of patients with CCHF in our hospital from January 2013 to December 2015 were divided into control group,perindopril group and union group,30 cases in each group.Patients in the control group were treated with conventional methods,patients in the perindopril group were treated with conventional methods and perindopril,and patients in the union group were treated with meglumine cyclic adenylate based on the treatment method of perindopril group.The treatment time of three groups were 2 weeks.Compared theclinical effect,LVEDD,LVESD,LVEF,6-minute walk distance and plasma levels of BNP,IGF-1,Cys-C between three groups.Results：After treatment,the clinical effect of the perindopril group （86.67%）and union group （96.67%） were significantly higher than that of the control group （66.67%）（P〈0.05）;LVEDD,LVESD,and plasma levels of BNP and Cys-C of three groups after treatment were all significantly lower than before treatment （P〉0.05）,and the perindopril group and union group were all significantly lower than that of the control group（P〈0.05）;LVEDD and plasma levels of BNP of union group were significantly higher than that of the perindopril group （P〈0.05）,and the perindopril group were all significantly higher than that of the union group （P〈0.05）.Conclusion：The clinical effect of meglumine cyclic adenylate and perindopril in patients with CCHF are remarkable,and meglumine cyclic adenylate can improve the effect ofperindopril on left ventricular remodelingsituation,left ventricular function,and patients＆#39; activity,and those may be related with modify the plasma levels ofBNP,IGF-1,Cys-C.