CAJ | 학술논문

目的：探讨环磷腺苷葡胺联合培哚普利治疗慢性心力衰竭（ CHF）的临床疗效及对氧化应激反应的影响。方法选取2011年2月—2014年6月彬县县医院收治的94例CHF患者，随机分为治疗组和对照组，各47例。两组患者均给予常规治疗，治疗组患者在常规治疗基础上采用环磷腺苷葡胺联合培哚普利治疗。比较两组患者临床疗效及用药安全性〔治疗期间血压、心率、血钾、丙氨酸氨基转移酶（ ALT）、天冬氨酸氨基转移酶（ AST）及肌酐变化〕，治疗前后心功能指标〔左心室舒张末期内径（ LVEDD）、左心室收缩末期内径（ LVESD）、左心室射血分数（ LVEF）、室间隔厚度（ IVST ）、左心室后壁厚度（ LVPWT ）及6分钟步行距离〕、氧化应激反应指标〔超氧化物歧化酶（SOD）、过氧化氢酶（CAT）、谷胱甘肽过氧化物酶（GSH-Px）及丙二醛（MDA）〕。结果治疗组患者显效18例、有效23例、无效6例，对照组患者显效6例、有效25例、无效16例，治疗组患者临床疗效优于对照组（ P<0.05）。两组患者治疗期间血压、心率、ALT及肌酐水平比较，差异无统计学意义（ P>0.05）；治疗组患者治疗期间血钾、AST水平低于对照组（ P<0.05）。治疗前两组患者LVEDD、LVESD、LVEF、IVST、LVPWT、6分钟步行距离及血浆SOD、CAT、GSH-Px及MDA水平比较，差异无统计学意义（ P>0.05）；治疗后治疗组患者LVEDD、LVESD、IVST、LVPWT均小于对照组，LVEF及血浆SOD、CAT、GSH-Px水平高于对照组，6分钟步行距离长于对照组，血浆MDA水平低于对照组（ P<0.05）。结论环磷腺苷葡胺联合培哚普利治疗CHF的临床疗效确切，能有效改善患者心功能，减轻氧化应激反应，且用药安全性高。
목적：탐토배린선감포알연합배타보리치료만성심력쇠갈（ CHF）적림상료효급대양화응격반응적영향。방법선취2011년2월—2014년6월빈현현의원수치적94례CHF환자，수궤분위치료조화대조조，각47례。량조환자균급여상규치료，치료조환자재상규치료기출상채용배린선감포알연합배타보리치료。비교량조환자림상료효급용약안전성〔치료기간혈압、심솔、혈갑、병안산안기전이매（ ALT）、천동안산안기전이매（ AST）급기항변화〕，치료전후심공능지표〔좌심실서장말기내경（ LVEDD）、좌심실수축말기내경（ LVESD）、좌심실사혈분수（ LVEF）、실간격후도（ IVST ）、좌심실후벽후도（ LVPWT ）급6분종보행거리〕、양화응격반응지표〔초양화물기화매（SOD）、과양화경매（CAT）、곡광감태과양화물매（GSH-Px）급병이철（MDA）〕。결과치료조환자현효18례、유효23례、무효6례，대조조환자현효6례、유효25례、무효16례，치료조환자림상료효우우대조조（ P<0.05）。량조환자치료기간혈압、심솔、ALT급기항수평비교，차이무통계학의의（ P>0.05）；치료조환자치료기간혈갑、AST수평저우대조조（ P<0.05）。치료전량조환자LVEDD、LVESD、LVEF、IVST、LVPWT、6분종보행거리급혈장SOD、CAT、GSH-Px급MDA수평비교，차이무통계학의의（ P>0.05）；치료후치료조환자LVEDD、LVESD、IVST、LVPWT균소우대조조，LVEF급혈장SOD、CAT、GSH-Px수평고우대조조，6분종보행거리장우대조조，혈장MDA수평저우대조조（ P<0.05）。결론배린선감포알연합배타보리치료CHF적림상료효학절，능유효개선환자심공능，감경양화응격반응，차용약안전성고。
Objective To investigate the clinical effect of meglumine adenosine cyclophosphate combined with perindopril on chronic heart failure and its impact on oxidative stress reaction. Methods A total of 94 patients with chronic heart failure were selected in the Hospital of Bin County from February 2011 to June 2014,and they were randomly divided into control group and treatment group,each of 47 cases. Patients of both groups were given regular treatment after admission,and patients of treatment were given extra meglumine adenosine cyclophosphate combined with perindopril. Clinical effect and drug safety ( including changes of blood pressure,heart rate,serum kalium,ALT,AST and Cr during treatment),cardiac function index ( including LVEDD, LVESD, LVEF, IVST, LVPWT and 6 - minute walk distance ), oxidative stress reaction index ( including plasma levels of SOD,CAT,GSH-Px,MDA) before and after treatment were compared between the two groups. Results In treatment group,18 cases got excellent effect,23 cases got good effect,6 cases were invalid;in control group,6 cases got excellent effect,25 cases got good effect,16 cases were invalid. The clinical effect of treatment group was statistically significantly better than that of control group(P<0. 05). No statistically significant differences of blood pressure,heart rate, ALT,or Cr was found between the two groups during treatment(P>0. 05),while serum kalium and AST of treatment group were statistically significantly lower than those of control group(P<0. 05). No statistically significant differences of LVEDD, LVESD,LVEF,IVST,LVPWT,6 - minute walk distance or plasma levels of SOD,CAT,GSH - Px,MDA was found between the two groups before treatment(P>0. 05);while after treatment,LVEDD,LVESD,IVST and LVPWT of treatment group were statistically significantly smaller than those of control groups,LVEF and plasma levels of SOD,CAT,GSH-Px of treatment group were statistically significantly higher than those of control group,6-minute walk distance of treatment group was statistically significantly longer than that of control groups,plasma MDA level of treatment group was statistically significantly lower than that of control group(P<0. 05). Conclusion Meglumine adenosine cyclophosphate combined with perindopril has certain clinical effect on chronic heart failure,which can effectively improve the patients'cardiac function,relieve the oxidative stress reaction,with high drug safety.