曲美他嗪对老年冠心病合并高血压病人血浆periostin、apelin的影响

Effects of trimetazidine on the level of plasma periostin and apelin in the treatment of elderly patients with coronary heart disease complicated with hypertension

目的研究曲美他嗪治疗老年冠心病合并高血压的疗效及对血浆periostin、apelin和内皮功能的影响。方法以2014年1月至2017年1月我院收治的120例老年冠心病合并高血压病人为研究对象,根据随机数字表法分为对照组和观察组,每组60例。对照组给予常规基础治疗,观察组在此基础上口服曲美他嗪,治疗3个月。比较2组的临床有效率,治疗前后的心功能、血压,血浆Periostin、Apelin以及血浆一氧化氮(NO)和内皮素-1(ET-1)的水平,观察2组不良反应。结果治疗前2组各观察指标差异均无统计学意义(P>0. 05)。2组临床有效率分别为93. 33%和80. 00%,差异有统计学意义(P<0. 05);治疗后2组血压显著降低、心功能均显著改善,且观察组二尖瓣舒张早期最大速度(E)与二尖瓣舒张晚期最大速度(A)比值(E/A)和左室射血分数(LVEF)显著高于对照组,收缩压和舒张压显著低于对照组,差异均有统计学意义(P<0. 05);治疗后2组periostin、ET-1明显下降,且观察组显著低于对照组(P<0. 05); apelin、NO明显上升,且观察组显著高于对照组(P<0. 05);治疗期间2组均未发生明显不良反应。结论曲美他嗪能够改善心功能,提高老年冠心病合并高血压的临床疗效,降低血浆peri-ostin、ET水平,升高血浆apelin和NO水平,改善内皮功能,安全有效。

Objective To analyze the clinical effect of trimetazidine in the treatment of coronary heart disease complicated with hypertension and the influence on plasma periostin,apelin and endothelial function in the elderly. Methods 120 elderly patients with coronary heart disease with hypertension from January 2014 to 2017 in our hospital were enrolled,and randomly divided into control group and observation group with 60 cases in each group. Control group was treated with basic treatment,and the observation group was treated with trimetazidine additionally. All patients were treated for 3 months. The clinical effect,the cardiac function,blood pressure,plasma levels of periostin,apelin,nitric oxide( NO)and endothelin-1( ET-1) before and after treatment were recorded, and the adverse effects were observed. Results Before treatment,all parameters of the two groups showed no significant difference( P>0. 05). The effective rate of the observation group and the control group was 93. 33%,80. 00%respectively,which showed significant difference( P<0. 05);After treatment,the levels of blood pressure were significanly decreased and the levels of E/A and left ventricular ejection fraction were significantly increased in both groups( P<0. 05),especially in the observation group( P<0. 05). After treatment,the levels of plasma periostin,ET-1 were significantly decreased,especially in the observation group. The levels of plasma apelin,NO were increased in both groups,especially in the observation group( P<0. 05).No obvious adverse effect occurred in the two groups. Conclusions Trimetazidine can effectively treat coronary heart disease complicated with hypertension in the elderly,improve the cardiac function,reduce the plasma levels of periostin,ET,improve the plasma levels of apelin and NO,and improve the endothelial function.