曲美他嗪联合三磷酸腺苷对老年冠状动脉粥样硬化性心脏病合并心力衰竭患者血清脂联素及心功能的影响

Study on the Effect of Trimetazidine Combined with Adenosine Triphosphate on Serum Adiponectin and Cardiac Function in Elderly Patients with Coronary Heart Disease and Heart Failure

目的探讨曲美他嗪联合三磷酸腺苷对老年冠状动脉粥样硬化性心脏病合并心力衰竭患者血清脂联素及心功能的影响。方法选取沈阳医学院附属第二医院2019年1月至2020年1月收治的老年冠状动脉粥样硬化性心脏病合并心力衰竭患者64例作为研究对象,采用随机数字表法分为试验组和对照组,各32例。对照组予以盐酸曲美他嗪片治疗,试验组在对照组治疗基础上采用三磷酸腺苷二钠片治疗,比较两组临床疗效、心功能指标、脂联素(APN)、N末端脑钠肽前体(NT-pro BNP)、6 min步行试验(6-MWT)及安全性。结果试验组治疗有效率高于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者左心室射血分数(LVEF)水平升高,左心室收缩末期内径(LVESD)、左心室舒张末期内径(LVEFDD)水平降低,与对照组比较,试验组患者LVEF水平较高,LVESD、LVEFDD水平较低,差异有统计学意义(P<0.05)。治疗后,两组患者APN、NT-pro BNP水平降低,6-MWT升高,与对照组比较,试验组患者APN、NT-pro BNP水平较低,6-MWT较高,差异有统计学意义(P<0.05)。两组患者不良反应发生率比较差异无统计学意义(P>0.05)。结论曲美他嗪联合三磷酸腺苷治疗冠状动脉粥样硬化性心脏病合并心力衰竭可有效降低患者血清APN水平,改善心功能和心力衰竭症状,安全性较高。

Objective To investigate the effect of trimetazidine combined with adenosine triphosphate on serum adiponectin and cardiac function in elderly patients with coronary heart disease and heart failure.Methods A total of 64 elderly patients with coronary heart disease and heart failure admitted to Second Affiliated Hospital of Shenyang Medical College were randomly divided into a control group and an experimental group,with 32 cases in each group.The control group was given trimetazidine hydrochloride tablets,and the experimental group was given adenosine triphosphate plus trimetazidine hydrochloride tablets.The clinical effect,cardiac function index,Adiponectin(APN),N-terminal pro-brain natriuretic peptide(NT-proBNP),6-minute walking distance and safety of all patients were compared.Results The effective rate of treatment in the experimental group was higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the left ventricular ejection fraction(LVEF)level of the 2 groups of patients increased,and the levels of left ventricular end systolic diameter(LVESD)and left ventricular end diastolic diameter(LVEFDD)decreased.Compared with the control group,the test group had higher LVEF levels,LVESD and LVEFDD levels were low,and the difference was statistically significant(P<0.05).After treatment,the APN and NT-proBNP levels of the 2 groups of patients decreased,and the 6-MWT increased.Compared with the control group,the test group had lower APN and NT-proBNP levels and higher 6-MWT levels.The difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the 2 groups of patients(P>0.05).Conclusion Trimetazidine combined with adenosine triphosphate in the treatment of coronary heart disease with heart failure can effectively reduce the serum APN level,improve the heart function and symptoms of heart failure,with high safety.