左西孟旦辅助治疗对老年慢性心力衰竭患者神经内分泌激素及细胞因子的影响

Effect of adjuvant levosimendan therapy on neuroendocrine hormones and cytokines in elderly patients with chronic heart failure

目的:探讨左西孟旦辅助治疗对老年慢性心力衰竭患者神经内分泌激素及细胞因子的影响。方法:选取100例在本院接受治疗的老年慢性心力衰竭患者,经随机数表法将入组患者分为对照组、左西孟旦组各50例。对照组患者接受临床慢性心力衰竭常规治疗,左西孟旦组接受常规治疗联合左西孟旦辅助治疗。对比两组患者治疗前后血清中RAAS指标、甲状腺激素、心肌损伤指标、内皮功能指标含量的差异。结果:T0时,两组血清中RAAS指标、甲状腺激素、心肌损伤指标、内皮功能指标含量的差异无统计学意义(P>0.05)。T1时,左西孟旦组血清中RAAS指标PRA、AngⅡ、ALD的含量低于对照组;左西孟旦组血清中甲状腺激素TT3、TT4、FT3、FT4的含量高于对照组;左西孟旦组血清中心肌损伤指标cTnⅠ、H-FABP、NT-proBNP的含量低于对照组;左西孟旦组血清中内皮功能指标NO的含量高于对照组,ET-1的含量低于对照组。结论:老年慢性心力衰竭患者接受左西孟旦辅助治疗,可有效调整机体神经内分泌激素分泌,减少心肌及血管内皮损伤。

Objective:To discuss the effect of adjuvant levosimendan therapy on neuroendocrine hormones and cytokines in elderly patients with chronic heart failure.Methods:100 elderly patients with chronic heart failure who were treated in the hospital between March 2014 and March 2017 were divided into control group and levosimendan group by random number table,each with 50 cases.Control group received clinical routine therapy for chronic heart failure,and levosimendan group received routine therapy combined with adjuvant levosimendan therapy.The differences in serum levels of RAAS indexes,thyroid hormones,myocardial damage indexes and endothelial function indexes were compared between the two groups before and after treatment.Results:At T0,there was no statistically significant difference in serum levels of RAAS indexes,thyroid hormones,myocardial damage indexes and endothelial function indexes between the two groups(P>0.05).At T1,serum RAAS indexes PRA,AngⅡ and ALD levels of levosimendan group were lower than those of control group;serum thyroid hormones TT3,TT4,FT3 and FT4 levels of levosimendan group were higher than those of control group;serum myocardial damage indexes cTnⅠ,H-FABP and NT-proBNP levels of levosimendan group were lower than those of control group;serum endothelial function index NO level of levosimendan group was higher than that of control group while ET-1 level was lower than that of control group.Conclusion:Adjuvant levosimendan therapy for elderly patients with chronic heart failure can effectively adjust the secretion of neuroendocrine hormones and reduce the myocardial and vascular endothelial damage.