卡维地洛联合硝酸异山梨酯在治疗重症心力衰竭中的疗效及其对血清CXCL10和CXCL12水平的影响

Efficacy of carvedilol combined with isosorbide dinitrate in the treatment of severe heart failure and influence on serum CXCL10 and CXCL12 levels

目的探讨卡维地洛联合硝酸异山梨酯治疗重症心力衰竭的疗效及其对趋化因子配体(CXCL)10和CXCL12水平的影响。方法选取2020年5月至2022年4月该院收治的106例重症心力衰竭患者作为研究对象,根据治疗方法不同分为对照组和联合组,每组各53例。对照组采用硝酸异山梨酯治疗,联合组采用卡维地洛联合硝酸异山梨酯治疗。比较两组临床疗效、治疗前后心功能指标[左室射血分数(LVEF)、心排出量(CO)、心脏指数(CI)、每搏输出量(SV)]水平、血清细胞因子[C反应蛋白(CRP)、白细胞介素-6(IL-6)、CXCL10、CXCL12]水平及主要不良心血管事件(MACE)发生率。结果联合组临床总有效率为96.23%,高于对照组的84.91%,差异有统计学意义(P<0.05);两组治疗后LVEF、CO、CI、SV水平均明显高于治疗前,且联合组治疗后均明显高于对照组,差异均有统计学意义(P<0.05);两组治疗后血清CRP、IL-6、CXCL10、CXCL12水平均明显低于治疗前,且联合组治疗后均明显低于对照组,差异均有统计学意义(P<0.05);治疗后随访6个月,联合组MACE总发生率为3.92%,低于对照组的18.37%,差异有统计学意义(P<0.05)。结论卡维地洛联合硝酸异山梨酯治疗重症心力衰竭疗效确切,有助于降低机体炎症反应,改善心功能,且安全性良好。

Objective To investigate the efficacy of carvedilol combined with isosorbide dinitrate in the treatment of severe heart failure and its effect on the levels of chemokine ligand(CXCL)10 and CXCL12.Methods A total of 106 patients with severe heart failure admitted to this hospital from May 2020 to April 2022 were selected as the research objects,and were divided into control group and combined group according to different treatment methods,with 53 cases in each group.The control group was treated with isosorbide dinitrate,and combined group was treated with carvedilol combined with isosorbide dinitrate.The clinical efficacy,cardiac function indexes[left ventricular ejection fraction(LVEF),cardiac output(CO),cardiac index(CI),stroke volume(SV)]levels,serum cytokines[C-reactive protein(CRP),interleukin-6(IL-6),CXCL10,CXCL12]levels and major adverse cardiovascular events and incidence of major adverse cardiovascular events(MACE)before and after treatment were compared between the 2 groups.Results The total effective rate of combined group was 96.23%,which was higher than 84.91%of control group,and the difference was statistically significant(P<0.05).The levels of LVEF,CO,CI and SV in the 2 groups after treatment were significantly higher than those before treatment,and those in combined group after treatment were significantly higher than those in control group,and the differences were statistically significant(P<0.05).The serum levels of CRP,IL-6,CXCL10 and CXCL12 in the 2 groups after treatment were significantly lower than those before treatment,and those in combined group after treatment were significantly lower than those in control group,with statistically significant differences(P<0.05).After 6 months of follow-up,the total incidence of MACE in combined group was 3.92%,which was lower than 18.37%in control group,and the difference was statistically significant(P<0.05).Conclusion Carvedilol combined with isosorbide dinitrate is effective in the treatment of severe heart failure,which is helpful to reduce the body′s inflammatory response,improve cardiac function,and has good safety.