左西孟旦联合托拉塞米治疗扩张型心肌病心力衰竭的效果及对心肌纤维化指标、神经内分泌因子的影响

Effect of levosimendan combined with torasemide in the treatment of dilated cardiomyopathy heart failure and its influences on myocardial fibrosis indexes and neuroendocrine factors

目的 探讨左西孟旦联合托拉塞米治疗扩张型心肌病心力衰竭的效果及对心肌纤维化指标、神经内分泌因子的影响。方法 选取2018年10月至2021年10月我院收治的80例扩张型心肌病心力衰竭患者为研究对象,以随机数字表法将其分为对照组和观察组,各40例。对照组给予托拉塞米治疗,观察组给予左西孟旦联合托拉塞米治疗。比较两组的治疗效果。结果 观察组的治疗总有效率高于对照组(P<0.05)。治疗后,观察组的左室射血分数(LVEF)高于对照组,左室收缩末期内径(LVESD)、左室舒张末期内径(LVEDD)及心肌肌钙蛋白I(cTnI)、N末端B型利钠肽前体(NT-proBNP)、透明质酸(HA)、Ⅲ型前胶原(PCⅢ)、去甲肾上腺素(NE)、醛固酮(ALD)及血管紧张素Ⅱ(AngⅡ)水平低于对照组(P<0.05)。结论 左西孟旦联合托拉塞米治疗扩张型心肌病心力衰竭有助于提高临床效果,改善心肌纤维化指标,下调神经内分泌因子,值得临床推广应用。

Objective To investigate the effect of levosimendan combined with torasemide in the treatment of dilated cardiomyopathy heart failure and its influences on myocardial fibrosis indexes and neuroendocrine factors.Methods A total of 80 patients with dilated cardiomyopathy heart failure admitted in our hospital from October 2018 to October 2021 were selected as the research objects.The patients were divided into control group and observation group by random number table method,with 40 cases in each group.The control group was treated with torasemide,and the observation group was treated with levosimendan combined with torasemide.The therapeutic effects of the two groups were compared.Results The total effective rate of treatment in the observation group was higher than that in the control group(P<0.05).After treatment,the left ventricular ejection fraction(LVEF)in the observation group was higher than that in the control group,and the left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD)and the levels of cardiac troponin I(cTnI),N-terminal pro-B type natriuretic peptide(NT-proBNP),hyaluronic acid(HA),typeⅢprocollagen(PCⅢ),norepinephrine(NE),aldosterone(ALD)and angiotensinⅡ(AngⅡ)were lower than those in the control group(P<0.05).Conclusion Levosimendan combined with torasemide in the treatment of dilated cardiomyopathy heart failure is helpful to improve the clinical effect,improve myocardial fibrosis indexes,and down-regulate neuroendocrine factors.It is worthy of clinical promotion and application.