左西孟旦治疗慢性心力衰竭的临床疗效及对神经激素、左室重构、微小RNA的影响

Clinical Efficacy of Levosimendan in the Treatment of Chronic Heart Failure and its Effect on Neurohormones,Left Ventricular Remodeling and MicroRNAs

目的:探讨左西孟旦治疗慢性心力衰竭(CHF)的临床疗效及对患者神经激素、左室重构、微小RNA的影响。方法:选取2022年1~12月期间于某院治疗的120例CHF患者作为研究对象,采用随机数字表法分为对照组和观察组,每组60例。对照组患者给予常规治疗,观察组患者在对照组治疗基础上加用左西孟旦注射液,共治疗2周。比较两组患者神经激素[醛固酮(ALD)、去甲肾上腺素(NE)及血管紧张素Ⅱ(AngⅡ)]、左室重构指标[平均室壁应力(MWS)、左室舒张末期内径(LVEDD)、左室质量指数(LVMI)、左房容积指数(LAVI)]、微小RNA[微小RNA-19b-3p(miR-19b-3p)、微小RNA-497(miR-497)和微小RNA-30a(miR-30a)]、临床疗效及不良反应发生情况。结果:治疗后,两组患者血清ALD、NE、AngⅡ水平均降低(P<0.05),且观察组低于对照组(P<0.05);MWS、LVEDD、LVMI、LAVI均降低(P<0.05),且观察组低于对照组(P<0.05);血清miR-19b-3p、miR-497均升高(P<0.05),且观察组高于对照组(P<0.05);血清miR-30a均降低(P<0.05),且观察组低于对照组(P<0.05)。观察组患者临床治疗总有效率(90.00%)高于对照组(68.33%,P<0.05)。两组患者不良反应发生率比较无统计学差异(P>0.05)。结论:在常规治疗基础上联合左西孟旦治疗CHF临床疗效较好,可有效改善患者血清神经激素、微小RNA水平,抑制左室重构,且不会增加不良反应的发生风险。

Objective:To investigate the clinical efficacy of levosimendan in the treatment of chronic heart failure(CHF)and its effect on neurohormones,left ventricular remodeling and microRNAs.Methods:A total of 120 CHF patients treated in a hospital from January to December 2022 were selected and assigned to the control group and observation group by random number table method,with 60 patients in each group.The control group was treated with conventional therapy,while the observation group was treated with levosimendan injection in addition to the treatment given in the control group,and both groups were treated for 2 weeks.Neurohormones[aldosterone(ALD),norepinephrine(NE)and angiotensinⅡ(AngⅡ)],left ventricular remodeling indexes[mean wall stress(MWS),left ventricular end-diastolic diameter(LVEDD),left ventricular mass index(LVMI),left atrial volume index(LAVI)],microRNAs[microRNA-19b-3p(miR-19b-3p),microRNA-497(miR-497)and microRNA-30a(miR-30a)],clinical response and adverse reactions were compared between the two groups.Results:After treatment,the serum levels of ALD,NE and AngⅡwere decreased in both groups(P<0.05),and were lower in the observation group than those in the control group(P<0.05).MWS,LVEDD,LVMI and LAVI were decreased in both groups(P<0.05),and were lower in the observation group than those in the control group(P<0.05).The serum levels of miR-19b-3p and miR-497 were increased in both groups(P<0.05),and were higher in the observation group than those in the control group(P<0.05).The serum miR-30a level was decreased in both groups(P<0.05),and was lower in the observation group than that in the control group(P<0.05).The total response rate in the observation group(90.00%)was higher than that in the control group(68.33%,P<0.05).No statistically significant difference in the incidence of adverse reactions was observed between the two groups(P>0.05).Conclusion:Levosimendan combined with conventional therapy has definite clinical efficacy in the treatment of CHF as demonstrated by effectively improved levels of serum neurohormones and microRNAs and inhibited left ventricular remodeling,without additional risks of adverse reactions.