卡维地洛联合曲美他嗪对心力衰竭患者血管内皮功能与血一氧化氮、内皮素-1的影响

Effect of Carvedilol combined with Trimetazidine on vascular endothelial function,blood nitric oxide and endothelin-1 in patients with heart failure

目的探讨卡维地洛联合曲美他嗪对心力衰竭患者血管内皮功能与血一氧化氮、内皮素-1的影响。方法选取2019年4月~2020年4月在沈阳医学院附属中心医院接受治疗的52例心力衰竭患者作为研究对象,采用抓阄法分为对照组与研究组,每组各26例。两组患者均给予血管扩张剂、利尿剂、紧张素抗结剂的常规治疗,对照组患者在常规治疗的基础上采用卡维地洛治疗,研究组患者在常规治疗的基础上采用卡维地洛联合曲美他嗪治疗。比较两组患者治疗前后的内皮素-1和血一氧化氮水平、左室舒张末期内径(LVDD)、左房内径(LAD)、左室射血分数(LVEF)和室间隔厚度(IVST)及治疗后的血管内皮功能。结果治疗前,两组患者的内皮素-1和血一氧化氮水平比较,差异无统计学意义(P>0.05);治疗后,两组患者的内皮素-1水平低于治疗前,血一氧化氮水平高于治疗前,差异有统计学意义(P<0.05);治疗后,研究组患者的内皮素-1水平低于对照组,血一氧化氮水平高于对照组,差异有统计学意义(P<0.05)。治疗后,研究组患者的血管舒张功能高于对照组,差异有统计学意义(P<0.05)。治疗前,两组患者的LVDD、LAD、LVEF、IVST比较,差异无统计意义(P>0.05);治疗后,两组患者的LVDD、LAD、IVST低于治疗前,LVEF高于治疗前,差异有统计学意义(P<0.05);治疗后,研究组患者的LVDD、LAD、IVST低于对照组,LVEF高于对照组,差异有统计学意义(P<0.05)。结论卡维地洛联合曲美他嗪治疗心力衰竭的效果理想,可以提高患者的血一氧化氮水平,降低内皮素-1水平,改善心功能,提高血管舒张功能,临床中建议推广使用。

Objective To investigate the effect of Carvedilol combined with Trimetazidine on vascular endothelial function,blood nitric oxide and endothelin-1 in patients with heart failure.Methods A total of 52 patients with heart failure who were treated in the Affiliated Central Hospital of Shenyang Medical University from April 2019 to April 2020 were selected as the research objects.By drawing lots,they were divided into control group and study group,with 26 cases in each group.Patients in both groups were given conventional treatment with vasodilators,diuretics and tensin anticoagulants.Patients in the control group were treated with Carvedilol on the basis of conventional treatment,and patients in the study group were treated with Carvedilol combined with Trimetazidine on the basis of conventional treatment.The levels of endothelin-1,blood nitric oxide,left ventricular end-diastolic diameter(LVDD),left atrial diameter(LAD),left ventricular ejection fraction(LVEF)and ventricular septal thickness(IVST)before and after treatment and vascular endothelial function after treatment were compared between the two groups.Results Before treatment,there were no statistically significant differences in the levels of endothelin-1 and nitric oxide between the two groups(P>0.05).After treatment,the levels of endothelin-1 in the two groups were lower than those before treatment,and the levels of blood nitric oxide were higher than those before treatment,the differences were statistically significant(P<0.05).After treatment,the level of endothelin-1 in the study group was lower than that in the control group,and the level of blood nitric oxide was higher than that in the control group,the differences were statistically significant(P<0.05).After treatment,the vasodilator function in the study group was higher than that in the control group,and the difference was statistically significant(P<0.05).Before treatment,there were no statistically significant differences in LVDD,LAD,LVEF and IVST between the two groups(P>0.05).After treatment,LVDD,LAD and IVST of the two groups were lower than those before treatment,LVEF was higher than before treatment,and the differences were statistically significant(P<0.05).After treatment,LVDD,LAD and IVST in the study group were lower than those in the control group,LVEF was higher than that in the control group,and the differences were statistically significant(P<0.05).Conclusion Carvedilol combined with Trimetazidine has an ideal effect in the treatment of heart failure.It can increase blood nitric oxide levels,reduce endothelin-1 levels,improve heart function,and improve vasodilation.It is recommended to be used in clinical practice.