CRT联合β受体阻断剂治疗慢性心力衰竭的临床疗效及对患者心功能的影响

Clinical Analysis of CRT Combined with βReceptor Blocker in the Treatment of Chronic Heart Failure and its Influence on the Cardiac Function of Patients

【目的】探讨心脏再同步化治疗(CRT)联合β受体阻断剂治疗慢性心力衰竭(CHF)的临床疗效及对患者心功能的影响。【方法】回顾性分析2017年7月至2020年2月长安医院收治的76例CHF患者的临床资料,根据治疗方法的不同将其分为观察组(CRT联合β受体阻断剂治疗,n=36)和对照组(β受体阻断剂治疗,n=40)。比较两组治疗前及治疗1个月、3个月、6个月后左室射血分数(LVEF)、左室舒张末径(LVEDD)和收缩末径(LVESD),比较血清脑钠肽(BNP)、肌钙蛋白I(cTnI)、C反应蛋白(CRP)、炎性因子肿瘤坏死因子(TNF-α)和白细胞介素-6(IL-6)水平,记录两组治疗期间不良反应发生情况。【结果】治疗1个月、3个月、6个月后,观察组LVEF高于治疗前,LVEDD、LVESD低于治疗前(P<0.05);对照组治疗后LVEF呈升高趋势,LVEDD、LVESD呈降低趋势,但差异无统计学意义(P>0.05)。治疗1个月、3个月、6个月后,观察组患者血清BNP、cTnI、CRP、TNF-α、IL-6水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);对照组治疗6个月后血清TNF-α、IL-6低于治疗前,差异有统计学意义(P<0.05)。两组治疗期间均出现疲乏、肢端发凉、心动过缓和肠胃不适的症状,但组间比较差异无统计学意义(P>0.05)。【结论】CRT联合β受体阻断剂治疗慢性心力衰竭可明显改善患者心功能,降低炎性因子水平,且不增加不良反应,值得临床推广。

【Objective】To investigate the clinical efficacy of cardiac resynchronization therapy(CRT)combined withβreceptor blockers in the treatment of chronic heart failure(CHF)and its influence on cardiac function.【Methods】The clinical data of 76 patients with CHF admitted to our hospital from July 2017 to February 2020 were analyzed retrospectively,and they were divided into the observation group(CRT combinedβreceptor blocker treatment,n=36)and control group(βreceptor blocker treatment,n=40).The left ventricular ejection fraction(LVEF),left ventricular end diastolic diameter(LVEDD)and left ventricular end systolic diameter(LVESD)were compared between the two groups before treatment and 1,3 and 6 months after treatment.The levels of serum brain natriuretic peptide(BNP),cardiac troponin I(cTnI),C-reactive protein(CRP),inflammatory factors,tumor necrosis factor a(TNF-α)and interleukin-6(IL-6)were compared,and the adverse reactions during treatment were recorded.【Results】After one month,three months and six months of treatment,LVEF in the observation group was higher than that before treatment,LVEDD and LVESD were lower than that before treatment(P<0.05);LVEF in the control group increased,LVEDD and LVESD decreased,but the difference was not statistically significant(P>0.05).After one month,three months and six months of treatment,the serum BNP,cTnI,CRP,TNF-αand IL-6 levels of patients in the observation group were lower than those before treatment,and those in the observation group were lower than those in the control group,with statistical significance(P<0.05);After 6 months of treatment,the levels of serum TNF-αand IL-6 in the control group were lower than those before treatment,and the difference was statistically significant(P<0.05).Both groups had symptoms of fatigue,limb cooling,bradycardia and gastrointestinal discomfort during treatment,but there was no significant difference between the two groups(P>0.05).【Conclusion】CRT combined withβreceptor blocker can significantly improve the cardiac function of patients with chronic heart failure,reduce the level of inflammatory factors,and do not increase adverse reactions,which is worthy of clinical promotion.