单硝酸异山梨酯注射液联合曲美他嗪对慢性收缩性心力衰竭患者血清相关因子及心功能的影响

Effects of isosorbide mononitrate injection and trimetazidine on serum levels of sICAM-1,ICAM-1,TGF-beta 1 and cardiac function in patients with chronic systolic heart failure

目的探讨单硝酸异山梨酯注射液联合曲美他嗪对慢性收缩性心力衰竭(CSHF)患者血清可溶性细胞黏附因子-1(sICAM-1)、细胞间粘附分子-1(ICAM-1)、转化生长因子-β1(TGF-β1)及心功能的影响。方法选择2014年8月~2016年10月收治的慢性收缩性心力衰竭患者110例进行分组,按抽签法随机分为对照组和试验组,每组55例。所有入院进行实验患者均接受常规治疗基础上,对照组给予单硝酸异山梨酯注射液治疗,试验组基于对照组加以曲美他嗪进行联合治疗。观察比较两组治疗前后两组临床疗效;血清sICAM-1、ICAM-1、TGF-β1水平;左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)和左室射血分数(LVEF)这三种反应心功能的指标。结果治疗后,试验组有效率高于对照组(P<0.05)。两组血清sICAM-1、ICAM-1、TGF-β1水平、及LVEDD和LVESD均显著下降,试验组明显低于对照组;两组LVEF均有明显上升,试验组高于对照组(P<0.05)。两组不良反应比较差异无统计学意义(P>0.05)。结论单硝酸异山梨酯注射液联合曲美他嗪对慢性收缩性心力衰竭的治疗效果肯定,不良反应少,能够降低血清sICAM-1、ICAM-1、TGF-β1水平,改善心功能。

Objective To investigate effects of isosorbide mononitrate injection and trimetazidine on serum levels of sICAM-1,ICAM-1,TGF-beta 1 and cardiac function in patients with chronic systolic heart failure.Methods 110 patients with chronic heart failure treated in our hospital from August 2014 to October ~2016 were retrospectively analyzed.They were randomly divided into the control group and the experimental group according to the draw method,55 cases in each group.All experimental admission of patients received conventional therapy based on the treatment.The control group was treated with isosorbide mononitrate injection treatment.The experimental group was treated with isosorbide mononitrate and trimetazidine.The clinical curative effect,the serum levels of sICAM-1,ICAM-1,TGF-beta1 level,left ventricular end diastolic diameter（LVEDD）,left ventricular end systolic diameter（LVESD）and left ventricular ejection fraction（LVEF）of these three kinds of cardiac function indexes were observed.Results After treatment,the effective rate of the experimental group（96.36%）was higher than that of the control group（70.91%）.The difference was statistically significant（P〈0.05）.The serum sICAM-1,ICAM-1,TGF-,and beta 1 levels LVEDD and LVESD of the two group were significantly decreased.The idexes of the experimental group were significantly lower than that of the control group.LVEF of the two groups were significantly increased.LVEF of experimental group waw higher than that of the control group（P〈0.05）.There was no difference in adverse reactions between the two groups（P〉0.05）.Conclusion Isosorbide mononitrate injection combined with trimetazidine is effective in the treatment of patients with chronic heart failure and has less adverse reactions.It can reduce the levels of serum sICAM-1,ICAM-1,TGF-beta1,and improve heart function.