| 王磊.前列地尔治疗慢性心力衰竭的效果及对心肌胶原容积分数、羟脯氨酸水平的影响[J].安徽医药,2020,24(8):1635-1638. |
| 前列地尔治疗慢性心力衰竭的效果及对心肌胶原容积分数、羟脯氨酸水平的影响 |
| The clinical effect of alprostadil in the treatment of CHF and its effect on the levels of CVF and HYP |
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| DOI：10.3969/j.issn.1009?6469.2020.08.041 |
| 中文关键词: 心力衰竭 前列地尔 羟脯氨酸 C反应蛋白质 每搏输出量 心肌胶原容积分数 |
| 英文关键词: Heart failure Alprostadil Hydroxyproline C?reative protein Stroke volume Collagen volume fraction |
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| 中文摘要: |
| 目的探讨前列地尔对慢性心力衰竭(CHF)的治疗效果及对心肌胶原容积分数(CVF)、羟脯氨酸(HYP)水平的影响。方法选取 2016年 3月至 2017年 4月在郑州市第七人民医院接受治疗的 80例 CHF病人为研究对象，并将其采用随机数字表法分为对照组和观察组，对照组给予利尿剂、血管紧张素转化酶抑制剂、 β?受体阻滞剂、地高辛等常规抗心力衰竭药物治疗，观察组在此基础上给予前列地尔治疗。观察两组病人的治疗效果，采用酶联免疫吸附法检测超敏 C?反应蛋白(hs?CRP)、肿瘤坏死因子 ?α(TNF?α)、 HYP水平，采用改良 Masson三色法染色计算 CVF，采用心脏超声显像仪检测左室每搏输出量(LVEF)、左房内径(LAD)、右房内径(RAD)。比较两组病人治疗前后心功能、 CVF、HYP水平的差异，并分析其安全性。结果观察组显效 23例(57.5%)明显优于对照组 15例(37.5%)(P＜0.05)；两组病人治疗前心功能指标差异无统计学意义，治疗后，观察组 LVEF［(59.45±5.23)%，比(55.12±5.02)%］和每搏输出量(SV)［(68.34±3.25)mL比(61.69±3.05)mL］高于对照组， LAD［(33.12±3.25) mm比(36.88±2.27)mm］、左室内径(LVD)［(38.19±3.22)mm比(42.03±3.16)mm］和 RAD［(36.65±4.12)mm比(45.76±3.52)mm］低于对照组；两组病人治疗前 CVF、HYP水平差异无统计学意义，治疗后，观察组 CVF［(2.53±0.52)比(3.82±0.68)］和 HYP［(32.34±4.22)μg/mg比(40.16±4.78)μg/mg］水平均低于对照组；两组病人在治疗期间，均未出现明显的肝、肾功能损伤等不良反应，其中对照组出现 2例血压过低， 1例心动过缓；观察组出现 1例血压过低， 1例心动过缓，两组安全性比较，差异无统计学意义。结论在常规药物的基础上应用前列地尔对慢性心力衰竭病人有较好的治疗效果，可明显改善病人的 CVF、HYP水平，具有良好的应用价值。 |
| 英文摘要: |
| Objective To explore the therapeutic effect of alprostadil on chronic heart failure(CHF)and its influence on the lev? els of collagen volume fraction(CVF)and hydroxyproline(HYP).Methods Eighty CHF patients who received treatment in The Seventh People’s Hospital of Zhengzhou from March 2016 to April 2017 were selected as the research subjects.They were random?ly assigned into control group and observation group.The control group was treated with diuretic，angiotensin converting enzyme in? hibitor，beta blocker，digoxin and other conventional anti heart failure drugs，and the observation group was treated with prostadil ad?ditionally.The treatment effects of two groups of patients were observed.The levels of high?sensitivity C?reactive protein(hs?CRP)， tumor necrosis factor alpha(TNF? alpha)and HYP were detected by enzyme linked immunosorbent assay.The CVF was calculat?ed by improved Masson tricolor staining.The left ventricular ejection fraction(LVEF)，the left atrial diameter(LAD)，and the right atrial diameter(RAD)were detected by the echocardiography.A comparison was made of the differences in cardiac function，CVF and HYP between the two groups before and after treatment，and its safety was analyzed.Results The clinical efficacy of the obser? vation group was significantly better than that of the control group(57.5% vs. 37.5%，P＜0.05)； there was no significant difference in cardiac function between the two groups before treatment.After treatment，The LVEF and stroke volume(SV) of the observation group were higher than those of the control group［(59.45±5.23)% vs.(55.12±5.02)%，(68.34±3.25)mL vs.(61.69±3.05)mL］， while LAD，left ventricular diameter(LVD)and RAD of the observation group were lower than those of the control group［(33.12±3.25)mm vs.(36.88±2.27)mm，(38.19±3.22)mm vs.(42.03±3.16)mm，(36.65±4.12)mm vs.(45.76±3.52)mm，respectively］.There were no difference in CVF and HYP between the two groups before treatment.After treatment，the CVF and HYP levels in the ob? servation group were lower than those in the control group［(2.53±0.52)vs.(3.82±0.68)，(32.34±4.22)μg/mg vs.(40.16±4.78) μg/mg，respectively］.In the two groups，there were no obvious adverse reactions such as liver and kidney function injury during the treatment.In the control group，there were 2 cases of low blood pressure and 1 case of bradycardia，while in the observation groupthere were 1 case of low blood pressure and 1 case of bradycardia.There was no difference between the two groups.Conclusion On the basis of conventional drugs，the application of alprostadil has a better therapeutic effect on patients with chronic heart fail? ure，which can significantly improve the patients’CVF and HYP levels，and has good application value. |
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