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硝苯地平与阿替洛尔治疗风湿性心脏病中度二尖瓣狭窄呈窦性心律的疗效与安全性比较
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| 篇名： | 硝苯地平与阿替洛尔治疗风湿性心脏病中度二尖瓣狭窄呈窦性心律的疗效与安全性比较 |
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| 摘要： | 目的：比较硝苯地平与阿替洛尔治疗风湿性心脏病中度二尖瓣狭窄呈窦性心律的疗效和安全性。方法：回顾性分析108例风湿性心脏病中度二尖瓣狭窄呈窦性心律患者资料，按用药方案的不同分为硝苯地平组（54例）和阿替洛尔组（54例）。在常规治疗的基础上，硝苯地平组患者给予硝苯地平缓释片（Ⅰ）20 mg，口服，每日1次；阿替洛尔组患者给予阿替洛尔片50 mg，口服，每日1次。两组疗程均为 8周。观察两组患者的临床疗效，治疗前后静息心率、心功能指标[左室收缩末期容积（LVESV）、左室舒张末期容积（LVEDV）、左室射血时间（LVET）、左室射血分数（LVEF）、左室质量指数（LVMI）、二尖瓣流速（E/A）]、B型脑钠肽（BNP）水平、超敏C反应蛋白（hs-CRP）水平、6 min步行距离及不良反应发生情况。结果：两组患者总有效率、不良反应发生率比较，差异均无统计学意义（P＞0.05）。治疗前，两组患者静息心率、心功能指标、BNP、hs-CRP水平、6 min步行距离比较，差异均无统计学意义（P＞0.05）。治疗后，两组患者静息心率、LVMI、BNP、hs-CRP水平均显著低于同组治疗前，且硝苯地平组LVMI、BNP、hs-CRP水平均显著低于阿替洛尔组；两组患者LVESV、LVEDV、LVET、LVEF、E/A、6 min步行距离均显著高于或长于同组治疗前，且硝苯地平组LVESV、LVET、LVEF、E/A、6 min步行距离均显著高于阿替洛尔组；差异均有统计学意义（P＜0.05或P＜0.01）；但两组间静息心率、LVEDV比较，差异均无统计学意义（P＞0.05）。结论：在常规治疗的基础上，硝苯地平与阿替洛尔治疗风湿性心脏病中度二尖瓣狭窄呈窦性心律的疗效和安全性均相当，但硝苯地平在改善患者心功能、神经内分泌因子水平和患者运动能力方面均优于阿替洛尔。 |
| ABSTRACT： | OBJECTIVE： To compare therapeutic efficacy and safety of nifedipine and atenolol in the treatment of moderate mitral stenosis in sinus rhythm rheumatic heart disease. METHODS： In retrospective analysis， a total of 108 patients with moderate mitral stenosis in sinus rhythm rheumatic heart disease were divided into nifedipine group （54 cases） and atenolol group （54 cases） according to therapeutic regimen. Based on routine treatment， nifedipine group was given Nifedipine sustained-release tablet （Ⅰ） 20 mg orally， once a day. Atenolol group was given Atenolol tablet 50 mg orally， once a day. Both groups received treatment for 8 weeks. Clinical efficacies as well as resting heart rate， cardiac function indexes （LVESV， LVEDV， LVET， LVEF， LVMI， E/A）， BNP and hs-CRP levels， 6 min walking distance， the occurrence of ADR before and after treatment were observed in 2 groups. RESULTS： There was no statistical significance in total response rate and the incidence of ADR between 2 groups （P＞0.05）. Before treatment，there was no statistical significance in the levels of resting heart rate，cardiac function indexes，BNP and hs-CRP，6 min walking distance between 2 group （P＞0.05）. After treatment， resting heart rate， LVMI， BNP and hs-CRP levels of 2 groups were significantly lower than before treatment， and LVMI， BNP and hs-CRP levels of nifedipine group were significantly lower than those of atenolol group； LVESV， LVEDV， LVET， LVEF， E/A and 6 min walking distance of 2 groups were significantly higher or longer than before treatment， and LVESV， LVET， LVEF， E/A and 6 min walking distance of nifedipine group were significantly higher than those of atenolol group； there was statistical significance （P＜0.05 or P＜0.01）. There was no statistical significance in resting heart rate and LVEDV between 2 groups （P＞0.05）. CONCLUSIONS： Based on routine treatment， nifedipine is similar to atenolol for moderate mitral stenosis in sinus rhythm rheumatic heart disease in therapeutic efficacy and safety. But nifedipine is better than atenolol in improving cardiac function， neuroendocrine factor levels and exercise ability. |
| 期刊： | 2017年第28卷第27期 |
| 作者： | 蔡濛，张萍 |
| AUTHORS： | CAI Meng，ZHANG Ping |
| 关键字： | 硝苯地平；阿替洛尔；中度二尖瓣狭窄；窦性心律；风湿性心脏病；疗效；安全性 |
| KEYWORDS： | Nifedipine； Atenolol； Moderate mitral stenosis； Sinus rhythm； Rheumatic heart disease； Therapeutic efficacy； Safety |
| 阅读数： | 422 次 |
| 本月下载数： | 7 次 |
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