芪苈强心胶囊联合沙库巴曲缬沙坦钠对老年慢性心力衰竭患者血清Gal-3、Copeptin水平及TLR4/NF-κB信号通路的影响

Effects of Qiliqiangxin Capsule Combined with Sacubitril Valsartan Sodium on Serum Gal-3,Copeptin Levels and TLR4/NF-κB Signal Pathway in Elderly Patients with Chronic Heart Failure

目的:观察芪苈强心胶囊联合沙库巴曲缬沙坦钠对老年慢性心力衰竭(CHF)患者血清半乳糖凝集素-3(Gal-3)、和肽素(Copeptin)水平及外周血单核细胞Toll样受体4(TLR4)/核转录因子-κB(NF-κB)信号通路的影响。方法:研究对象为我院2019年8月~2021年3月期间收治的97例老年CHF患者,根据随机数字表法分为对照组和研究组,分别为48例和49例,对照组接受沙库巴曲缬沙坦钠治疗,研究组接受芪苈强心胶囊联合沙库巴曲缬沙坦钠治疗,两组均治疗3个月。对比两组疗效、血清Gal-3及Copeptin水平、外周血单核细胞TLR4/NF-κB信号通路相关指标、心功能指标及6 min步行实验(6MWT)距离。记录两组用药安全性。结果:研究组(93.88%)的临床总有效率明显高于对照组(72.92%)(P<0.05)。研究组治疗3个月后左心室射血分数(LVEF)、每搏输出量(SV)、心输出量(CO)高于对照组,6MWT距离长于对照组(P<0.05)。研究组治疗3个月后血清Gal-3、Copeptin水平低于对照组(P<0.05)。研究组治疗3个月后TLR4 mRNA、NF-κB mRNA、白介素-6(IL-6)mRNA、肿瘤坏死因子-α(TNF-α)mRNA均低于对照组(P<0.05)。两组不良反应发生率对比无差异(P>0.05)。结论:老年CHF患者采用沙库巴曲缬沙坦钠联合芪苈强心胶囊治疗,可调节血清Gal-3、Copeptin水平,改善患者心功能和运动耐力,可能通过抑制患者外周血单核细胞TLR4/NF-κB信号通路发挥作用。

Objective:To observe the effects of Qiliqiangxin capsule combined with sacubatro valsartan sodium on serum Galectin-3(Gal-3)and Copeptin(Copeptin)levels and monocyte toll like receptor 4(TLR4)/nuclear transcription factor-κB(NF-κB)signal pathway of peripheral blood monocytes in elderly patients with chronic heart failure.Methods:97 elderly patients with CHF who were treated in our hospital from August 2019 to March 2021 were selected,they were randomly divided into control group and study group,48 cases and 49 cases respectively.The control group was treated with sacubatrovalsartan sodium,and the study group was treated with Qiliqiangxin capsule compared with sacubatrovalsartan sodium.Both groups were treated for 3 months.The efficacy,serum Gal-3 and copeptin levels,peripheral blood monocyte TLR4/NF-κB signal pathway related indexes,cardiac function indexes and 6-min walking test(6 MWT)distance were compaerd between the two groups.The medication safety of the two groups was recorded.Results:The total clinical effective rate of the study group(93.88%)was significantly higher than that of the control group(72.92%)(P<0.05).3 months after treatment,the left ventricular ejection fraction(LVEF),stroke output(SV)and cardiac output(CO)in the study group were higher than those in the control group,and the 6 MWT distance was longer than that in the control group(P<0.05).The levels of serum Gal-3 and copeptin in the study group were lower than those in the control group at 3 months after treatment(P<0.05).TLR4 mRNA,NF-κB mRNA,interleukin-6(IL-6)mRNA,tumor necrosis factor-α(TNF-α)mRNA in the study group 3 months after treatment were lower than that in the control group(P<0.05).There was no difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion:Elderly patients with CHF treated with salkubatroxartan sodium combined with Qiliqiangxin capsule can adjust the levels of serum Gal-3 and copeptin,improve their cardiac function and exercise endurance,it may inhibit TLR4/NF-κB of peripheral blood monocytes signal pathway plays a role.