曲美他嗪对高血压合并心力衰竭患者心功能及NT-proBNP、Hcy、cTnI水平的影响

Effects of Trimetazidine on Cardiac Function and NT-proBNP,Hcy,cTnI Level in Patients with Hypertension Complicated with Heart Failure

目的:探讨曲美他嗪对高血压合并心力衰竭患者心功能及N末端脑钠肽前体(NT-proBNP)、同型半胱氨酸(Hcy)、肌钙蛋白I(cTnI)水平的影响。方法:将2016年9月-2018年9月于笔者所在医院就诊的高血压合并心力衰竭患者92例纳入研究,并随机分组,对照组46例予以常规治疗,观察组46例在此基础上予以曲美他嗪治疗。比较患者治疗前后的心功能指标,NT-proBNP、Hcy、cTnI水平,内皮功能,临床综合疗效。结果:治疗后两组左心室收缩末期内径(LVESD)及左心室舒张末期内径(LVEDD)下降,左心室射血分数(LVEF)升高,观察组心功能指标优于对照组,差异有统计学意义(P<0.05);治疗后两组NT-proBNP、Hcy、cTnI含量下降,观察组上述指标明显低于对照组,差异有统计学意义(P<0.05);治疗后两组内皮素1(ET-1)下降,血清一氧化氮(NO)升高,观察组变化幅度大于对照组,差异有统计学意义(P<0.05);观察组总有效率为91.3%,高于对照组的71.7%,差异有统计学意义(P<0.05)。结论:在常规西医治疗基础上,应用曲美他嗪治疗高血压合并心力衰竭的效果突出,可以改善NTproBNP等相关指标,促进心功能的恢复,提高生存质量,具有一定的临床意义。

Objective:To investigate the effects of Trimetazidine on cardiac function,N terminal brain natriuretic peptide precursor(NT-proBNP) and homocysteine(Hcy),troponin I(cTnI) levels in hypertensive patients with heart failure.Method:From September 2016 to September 2018,92 patients with hypertension complicated with heart failure were enrolled in the study and randomly divided into two groups.46 patients in the control group were treated with routine treatment,and 46 patients in the observation group were treated with Trimetazidine on the basis of routine treatment.The indexes of cardiac function,NTproBNP,Hcy,cTnI level,endothelial function and clinical comprehensive curative effect were compared before and after treatment.Result:After treatment,the left ventricular end-systolic diameter(LVESD) and left ventricular end-diastolic diameter(LVEDD) decreased and left ventricular ejection fraction(LVEF) increased in the two groups.The index of cardiac function in the observation group was better than that in the control group(P<0.05).After treatment,the content of NTproBNP,Hcy,cTnI in the two groups decreased,and the above indexes in the observation group were significantly lower than those in the control group(P<0.05).After treatment,endothelin-1(ET-1) decreased and serum nitric oxide(NO) increased in the two groups.The range of changes in the observation group was greater than that in the control group,and the differences were statistically significant(P<0.05).The total effective rate of the observation group was 91.3%,which was higher than 71.7% of the control group,the difference was statistically significant(P<0.05).Conclusion:On the basis of routine western medicine,Trimetazidine is effective in the treatment of hypertension complicated with heart failure.It can improve the related indexes such as NT-proBNP,promote the recovery of cardiac function and improve the quality of life.It has certain clinical significance.