胸腺五肽联合卡维地洛治疗扩张型心肌病的临床研究

Clinical study on thymopentin combined with carvedilol in treatment of dilated cardiomyopathy

目的探讨胸腺五肽联合卡维地洛治疗扩张型心肌病的临床疗效。方法选取2014年1月—2016年1月武汉航运医院收治的扩张型心肌病患者68例,根据治疗方案不同分为对照组和治疗组,每组各34例。对照组口服卡维地洛片,初始剂量2.5 mg/次,2次/d,每1~2周递增1次,最大剂量为25 mg/次,2次/d。治疗组在对照组治疗基础上肌肉注射胸腺五肽注射液,10 mg与生理盐水1 mL配伍,1次/d。4周为1个疗程。2组均治疗2个疗程后进行疗效评价。观察两组的临床疗效,比较两组患者治疗前后6 min步行距离(6MWD)、B型尿钠肽(BNP)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)水平的变化情况。结果治疗后,对照组和治疗组的总有效率分别为67.65%、88.24%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组6MWD显著增多,血清hs-CRP、BNP、TNF-α水平均明显下降,同组治疗前后比较差异有统计学意义(P<0.05);治疗后,治疗组6MWD高于对照组,hs-CRP、BNP、TNF-α低于对照组,两组比较差异有统计学意义(P<0.05)。结论胸腺五肽联合卡维地洛治疗扩张型心肌病具有较好的临床疗效,可有效改善患者的临床症状,降低机体的炎症反应,具有一定的临床推广应用价值。

Objective To investigate the clinical efficacy of thymopentin combined with carvedilol in treatment of dilated cardiomyopathy. Methods Patients（68 cases） with dilated cardiomyopathy in Wuhan Shipping Hospital from January 2016 to January 2017 were divided into control（34 cases） and treatment（34 cases） groups based on different treatments. Patients in the control group were po administered with Carvedilol Tablets, and the initial dosage was 2.5 mg/time, twice daily, increments every 1 to 2 weeks, the maximum dosage was 25 mg/time, twice daily. Patients in the treatment group were iv administered with Thymopentin Injection on the basis of the control group, 10 mg added into normal saline 1 mL, once daily. A course of treatment was 4 weeks, and patients in two groups were treated for 2 courses. After treatment, the clinical efficacies were evaluated, and 6MWD, BNP, hs-CRP, and TNF-α in two groups before and after treatment were compared. Results After treatment, the clinical efficacies in the control and treatment groups were 67.65% and 88.24%, respectively, and there was difference between two groups（P〈0.05）. After treatment, 6MWD was significantly increased, and hs-CRP, BNP, and TNF-α in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. After treatment, 6MWD in the treatment group was higher than that in the control group, and hs-CRP, BNP, and TNF-α in the treatment group were significantly lower than those in the control group, and the difference was statistically significant between two groups（P〈0.05）. Conclusion Thymopentin combined with carvedilol has clinical curative effect in treatment of dilated cardiomyopathy, and can effectively improve the clinical symptoms and reduce the inflammation of the body, which has a certain clinical application value.