银杏酮酯滴丸联合美托洛尔治疗扩张型心肌病心力衰竭的效果及对心室重构的影响

Efficacy of Ginkgolone Ester Drops Combined with Metoprolol in the Treatment of Dilated Cardiomyopathy Heart Failure and its Effect on Ventricular Remodeling

目的探讨银杏酮酯滴丸联合美托洛尔治疗扩张型心肌病心力衰竭的效果及对心室重构的影响。方法选取2019年1月—2022年12月内蒙古自治区人民医院收治的120例扩张型心肌病心力衰竭患者的病历资料进行分析,按治疗方式分为对照组(n=60)和观察组(n=60)。两组均应用常规治疗,对照组加用美托洛尔,观察组在对照组基础上联合银杏酮酯滴丸治疗,两组患者均持续治疗6周。比较两组患者治疗效果、心功能[左室舒张末期内径(LVEDD)、左室射血分数(LVEF)]、炎症因子水平[N末端脑钠肽前体(NTpro-BNP)、肿瘤坏死因子α(TNF-α)、超敏C-反应蛋白(hs-CRP)]、心室重构功能[血清基质金属蛋白酶-9(MMP-9)、Ⅰ型前胶原氨基末端肽(PⅠNP)、Ⅲ型前胶原氨基末端肽(PⅢNP)]以及不良反应发生情况。结果观察组治疗总有效率明显高于对照组,差异有统计学意义(P<0.05)。治疗后,两组患者LVEDD水平均明显降低,且观察组降低幅度更大,差异有统计学意义(P<0.05);两组患者LVEF水平均明显升高,且观察组升高幅度更大,差异有统计学意义(P<0.05)。治疗后,两组患者NTpro-BNP、TNF-α、hs-CRP水平均降低,且观察组较对照组低,差异有统计学意义(P<0.05)。治疗后,两组患者PⅠNP、PⅢNP、MMP-9水平均降低,且观察组较对照组低,差异有统计学意义(P<0.05)。两组不良反应发生率相比,差异无统计学意义(P>0.05)。结论银杏酮酯滴丸联合美托洛尔治疗扩张型心肌病心力衰竭效果显著,可改善患者心功能,降低患者炎症反应,抑制心室重构,安全性高。

Objective To investigate the effect of ginkgolone ester drops combined with metoprolol in the treatment of heart failure in dilated cardiomyopathy and its effect on ventricular remodeling.Methods The case data of 120 patients with heart failure with dilated cardiomyopathy admitted to Inner Mongolia Autonomous Region People's Hospital were analyzed(January 2019 to December 2022),and divided into control group(n=60)and observation group(n=60)by random number table method.Both groups continued treatment for 6 weeks.Comparing the treatment effect,cardiac function[left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)],inflammatory factor level[N-terminal brain natriuretic peptide precursor(NTpro-BNP),tumor necrosis factorα(TNF-α),hypersensitivity C-reactive protein(hs-CRP),ventricular remodeling function[serum matrix metalloproteinase-9(MMP-9),type I precollagen amino-terminal peptide(PI.NP),type III precollagen amino-terminal peptide(PIII.NP)]and the occurrence of adverse effects.Results The total effective rate of treatment in the observation group was significantly higher than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the LVEDD level in both groups was significantly reduced,and the decrease was greater in the observation group than in the two groups,with a statistically significant difference(P<0.05),and the LVEF level in both groups was significantly increased,and the increase in the observation group was greater than that in the two groups,and the difference was statistically significant(P<0.05).After treatment,the levels of NTpro-BNP,TNF-αand hs-CRP were reduced in both groups,and the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).After treatment,the levels of PI.NP,PIII.NP and MMP-9 were reduced in both groups,and the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Ginkgolone ester drops combined with metoprolol have a significant effect in the treatment of dilated cardiomyopathy heart failure,which can improve cardiac function,reduce inflammatory response and inhibit ventricular remodeling.