[关键词]
[摘要]
目的 探究曲美他嗪辅助卡维地洛治疗高血压性心脏病的疗效及对p38MAPK水平的影响。方法 选择开封市祥符区中医院2016年10月-2018年10月收治的高血压性心脏病患者106例为研究对象,根据其入院顺序经随机数字表法分为两组,每组53例。其中,对照组给予卡维地洛进行治疗,观察组在对照组基础上联合曲美他嗪进行治疗,对比两组患者的超声心动图测定各指标、血压变化和血清TNF-α、IL-6、p38MAPK水平。结果 治疗前,两组患者的左室射血分数(LVEF)、左室舒张末期内径(LVDD)、左室收缩末期内径(LVSD)、左房内径(LAD)、室间隔厚度(IVST)水平对比无显著性差异;治疗后,两组患者的LVDD、LVSD、LAD、IVST水平均比治疗前显著降低(P<0.05),且观察组显著低于对照组(P<0.05);治疗后,两组患者的LVEF水平均比治疗前显著升高(P<0.05),且观察组显著高于对照组(P<0.05)。治疗前,两组患者的收缩压(SBP)、舒张压(DBP)水平对比无显著性差异;治疗后,两组患者的SBP、DBP水平均比治疗前显著降低(P<0.05),且观察组显著低于对照组(P<0.05)。治疗前,两组患者的血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、P38丝裂原活化蛋白激酶(p38MAPK)水平对比无显著性差异;治疗后,两组患者的血清TNF-α、IL-6、p38MAPK水平均比治疗前显著降低(P<0.05),且观察组显著低于对照组(P<0.05)。结论 曲美他嗪辅助卡维地洛治疗高血压性心脏病的效果显著,该方法可有效降低患者的血压水平和炎症因子水平,并抑制p38MAPK活化,临床应用效果显著。
[Key word]
[Abstract]
Objective To investigate the effect of trimetazidine-assisted carvedilol on hypertensive heart disease and its effect on p38MAPK. Methods A total of 106 patients with hypertensive heart disease admitted to Xiangfu District Hospital of Traditional Chinese Medicine from October 2008 to October 2018 were enrolled in the study. According to their admission order, they were divided into two groups according to the random number table method, with 53 cases in each group. Among them, the control group was treated with carvedilol, and the study group was treated with trimetazidine on the basis of the control group. The indexes, blood pressure changes, and serum TNF-α, IL-6 and p38 MAPK levels were measured by echocardiography in two groups. Results Before treatment, there was no significant difference in the levels of LVEF, LVDD, LVSD, LAD and IVST between two groups. After treatment, the LVDD, LVSD, LAD, and IVST levels of two groups were significantly lower than those before treatment (P<0.05), and the patients in the study group were lower than those in the control group (P<0.05). After treatment, the LVEF levels of two groups were significantly higher than those before treatment (P<0.05), and the patients in the study group were higher than those in the control group (P<0.05). Before treatment, there was no significant difference in SBP and DBP levels between two groups. After treatment, the SBP and DBP levels in two groups were significantly lower than those before treatment (P<0.05), and the patients in the study group were lower than those in the control group (P<0.05). Before treatment, there was no significant difference in serum TNF-α, IL-6, and p38MAPK levels between two groups. After treatment, serum TNF-α, IL-6, and p38 MAPK levels were significantly decreased (P<0.05), and the indexes in the study group were significantly lower than those in the control group (P<0.05). Conclusion Trimetazidine-assisted carvedilol is effective in treatment of hypertensive heart disease. This method can effectively reduce the blood pressure level and inflammatory factor levels, and inhibit the activation of p38MAPK. The clinical application effect is significant.
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[基金项目]
2017年河南省科学技术项目(9412017Y0439)