CAJ | 학술논문

目的：探讨厄贝沙坦联合环磷腺苷葡胺治疗慢性心力衰竭（ CHF）的临床疗效及对心功能和氧化应激反应的影响。方法选择2011年6月—2014年8月攀枝花市第二人民医院收治的CHF患者104例，随机分为治疗组和对照组，各52例。两组患者均给予常规抗心力衰竭治疗，治疗组患者加用厄贝沙坦和环磷腺苷葡胺，两组患者疗程均为2周。观察两组患者临床疗效及治疗期间不良反应发生情况，比较两组患者治疗前后心功能指标〔包括左心室收缩末期内径（ LVESD）、左心室舒张末期内径（ LVEDD）、左心室射血分数（ LVEF）、室间隔厚度（ IVST）、左心室后壁厚度（ LVPWT）及心脏指数（ CI）〕、血浆脑利钠肽（ BNP）水平及氧化应激反应指标〔血浆丙二醛（ MDA）、过氧化氢酶（CAT）、谷胱甘肽过氧化物酶（GSH－Px）水平〕。结果治疗组患者临床疗效优于对照组（u＝3.044， P＝0.002）。治疗前两组患者CI、 LVESD、 LVEDD、 LVEF、 IVST、 LVPWT比较，差异无统计学意义（P＞0.05）；治疗后治疗组患者CI和LVEF高于对照组， LVESD、 LVEDD、 IVST及LVPWT低于对照组（ P＜0.05）。治疗前两组患者血浆BNP及CAT、 GSH－Px、 MDA水平比较，差异无统计学意义（P＞0.05）；治疗后治疗组患者血浆BNP和MDA水平低于对照组，血浆CAT和GSH－Px水平高于对照组（ P＜0.05）。观察组患者不良反应发生率为3.8％，对照组为1.9％，差异无统计学意义（P＞0.05）。结论厄贝沙坦联合环磷腺苷葡胺治疗CHF安全有效，可有效减轻患者氧化应激反应、改善患者心功能。
목적：탐토액패사탄연합배린선감포알치료만성심력쇠갈（ CHF）적림상료효급대심공능화양화응격반응적영향。방법선택2011년6월—2014년8월반지화시제이인민의원수치적CHF환자104례，수궤분위치료조화대조조，각52례。량조환자균급여상규항심력쇠갈치료，치료조환자가용액패사탄화배린선감포알，량조환자료정균위2주。관찰량조환자림상료효급치료기간불량반응발생정황，비교량조환자치료전후심공능지표〔포괄좌심실수축말기내경（ LVESD）、좌심실서장말기내경（ LVEDD）、좌심실사혈분수（ LVEF）、실간격후도（ IVST）、좌심실후벽후도（ LVPWT）급심장지수（ CI）〕、혈장뇌리납태（ BNP）수평급양화응격반응지표〔혈장병이철（ MDA）、과양화경매（CAT）、곡광감태과양화물매（GSH－Px）수평〕。결과치료조환자림상료효우우대조조（u＝3.044， P＝0.002）。치료전량조환자CI、 LVESD、 LVEDD、 LVEF、 IVST、 LVPWT비교，차이무통계학의의（P＞0.05）；치료후치료조환자CI화LVEF고우대조조， LVESD、 LVEDD、 IVST급LVPWT저우대조조（ P＜0.05）。치료전량조환자혈장BNP급CAT、 GSH－Px、 MDA수평비교，차이무통계학의의（P＞0.05）；치료후치료조환자혈장BNP화MDA수평저우대조조，혈장CAT화GSH－Px수평고우대조조（ P＜0.05）。관찰조환자불량반응발생솔위3.8％，대조조위1.9％，차이무통계학의의（P＞0.05）。결론액패사탄연합배린선감포알치료CHF안전유효，가유효감경환자양화응격반응、개선환자심공능。
Objective To investigate the clinical effect of irbesartan combined with meglumine adenosine cyclophosphate on chronic heart failure and its impact on cardiac function and oxidative stress reaction.Methods A total of 104 patients with chronic heart failure were selected in the Second People′s Hospital of Panzhihua from June 2011 to August 2014, and they were randomly divided into control group and experiment group, each of 52 cases.Patients of both groups were given conventional treatment for heart failure, while patients of experiment group were given extra irbesartan combined with meglumine adenosine cyclophosphate for 2 weeks.Clinical effect and incidence of adverse reactions during treatment were observed, cardiac function index ( including LVESD, LVEDD, LVEF, IVST, LVPWT and CI ) , plasma BNP level and oxidative stress index ( including plasma levels of MDA, CAT and GSH-Px ) before and after treatment were compared between the two groups. Results The clinical effect of experiment group was statistically significantly better than that of control group (u=3.044, P=0.002) .No statistically significant differences of LVESD, LVEDD, LVEF, IVST, LVPWT or CI was found between the two groups before treatment ( P >0.05 ); after treatment, LVESD, LVEDD, IVST and LVPWT of experiment group were statistically significantly lower than those of control group, while LVEF and CI of experiment group were statistically significantly higher than those of control group ( P<0.05 ) .No statistically significant differences of plasma level of BNP, MDA, CAT or GSH-Px was found between the two groups before treatment ( P>0.05); after treatment, plasma levels of BNP and MDA of experiment group were statistically significantly lower than those of control group, while plasma levels of CAT and GSH-Px of experiment group were statistically significant higher than those of control group (P<0.05).The incidence of adverse reactions of experiment group was 3.8%during treatment, that of control group was 1.9%, the difference was not statistically significantly different ( P>0.05 ) . Conclusion Irbesartan combined with meglumine adenosine cyclophosphate is effective and safe in treating chronic heart failure, which can effectively relieve the oxidative stress reaction and improve the cardiac function.