银杏酮酯滴丸联合美托洛尔治疗慢性心力衰竭患者的疗效及对血清炎症因子、心肌纤维化的影响

Efficacy of ginkgo ketone ester dripping pillscombined with metoprolol in treatment of chronic heart failure and its effect on serum inflammatory factors and myocardial fibrosis

目的:探讨银杏酮酯滴丸联合美托洛尔治疗慢性心力衰竭患者的临床疗效及对血清炎性因子、心肌纤维化指标的影响。方法:选择2018年1月至2019年12月就诊于本院心内科并符合慢性心力衰竭诊断标准的128例患者为研究对象,将研究对象随机分为对照组和观察组,每组64例,在常规抗心力衰竭治疗基础上,对照组给予美托洛尔治疗,观察组在对照组基础上给予银杏酮酯滴丸。比较两组患者治疗前、后的临床疗效,采用6 min步行试验及Lee氏心衰评分进行心衰功能、症状评价,采用ELISA法检测心肌纤维化指标N末端B型利钠肽原(NT-pro BNP)、转化生长因子-β1(TGF-β1)、结缔组织生长因子(CTCF)及炎性因子可溶性CD40配体(sCD40L)、白介素18(IL-18)、白激素6(IL-6)及超敏C反应蛋白(hs-CRP)水平,并进行安全性评价。结果:治疗后,观察组的总有效率83.33%明显高于对照组的76.56%(P<0.05);两组患者Lee氏心衰评分均明显下降,6 min步行距离显著增加,且观察组两项指标降低及增加更为显著(P<0.05);两组患者NT-pro BNP、TGF-β1、CTCF水平及sCD40L、IL-18、IL-6及hs-CRP水平均显著降低,且观察组降低更为显著(P<0.05);两组心功能均显著改善,左室射血分数(LVEF)显著升高,左心室舒张末期内径(LVEDD)及左心室收缩末期容积(LVESV)均显著降低,且观察组改善程度尤为显著(P<0.05),两组不良反应发生率比较,差异无统计学意义(P>0.05)。结论:银杏酮酯滴丸联合美托洛尔对慢性心力衰竭患者具有良好的临床疗效,其能够降低患者心肌纤维化及炎性因子水平,改善心功能指标,具有一定的临床推广应用价值。

Objective:To investigate the clinical efficacy of Ginkgo ketone ester dripping pillscombined with metoprolol in the treatment of patients with chronic heart failure and its effect on serum inflammatory factors and myocardial fibrosis parameters.Methods:A total of 128 patients who visited the cardiology department of our hospital from January 2018 to December 2019 and met the diagnostic criteria of chronic heart failure were selected as study subjects and randomly divided into a control group and an observation group,with 64 cases in each group.On the basis of conventional anti-heart failure treatment,the control group was given metoprolol treatment and the observation group was given ginkgo ketone ester dripping pillsin combination with meteprolol.The clinical efficacy of the two groups was compared before and after treatment.Heart failure function and symptoms were evaluated by 6 min walk test(6 MWT)and Lee’s heart failure score,the levels of N-terminal prob-type natriuretic peptide(NT-pro BNP),transforming growth factor-β1(TGF-β1),connective tissue growth factor(CTGF)as well as inflammatory factors soluble CD40 ligand(sCD40L),interleukin 18(IL-18),interleukin 6(IL-6)and hypersensitive C-reactive protein(hs-CRP)were measured using ELISA,and safety evaluation was performed.Results:After treatment,the overall efficacy rate of 83.33%in the observation group was significantly higher than that of 76.56%in the control group(P<0.05);in both groups,the Lee’s heart failure score decreased significantly while the 6 min walking distance increased significantly,and the decrease and increase of these indicators in the observation group were more significant(P<0.05);the levels of NT-pro BNP,TGF-β1,CTGF,sCD40L,IL-18,IL-6 and hs-CRP in both groups decreased significantly,and the decrease in the observation group was more significantthan that in the control group(P<0.05);cardiac functions improved significantly in both groups,as the left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVEDD)and left ventricular end-systolic volume(LVESV)were all significantly reduced in both groups,and the reduction was more significant in the observation group(P<0.05).The incidence of adverse events in the two groups was compared,and the difference was not statistically significant(P>0.05).Conclusion:Ginkgo ketone ester dripping pillscombined with metoprolol has good clinical efficacy in patients with chronic heart failure.It can reduce the levels of myocardial fibrosis and inflammatory factors and improve cardiac function indices,and thus deserveswider clinical application.