奥美沙坦酯对慢性心力衰竭患者心功能、血浆N端脑钠肽前体和血清白细胞介素23水平的影响
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篇名: 奥美沙坦酯对慢性心力衰竭患者心功能、血浆N端脑钠肽前体和血清白细胞介素23水平的影响
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摘要: 目的:探讨奥美沙坦酯对慢性心力衰竭(CHF)患者心功能、血浆N端脑钠肽前体(NT-proBNP)和血清白细胞介素23(IL-23)水平的影响,并对其安全性进行评价。方法:选取2014年12月-2016年5月江苏省涟水县人民医院收治的CHF患者40例作为研究对象,按照随机数字表法分为对照组和观察组,各20例。对照组患者给予马来酸依那普利片起始剂量5 mg,po,qd(1周后逐渐增大剂量,限制剂量为20 mg/d)+酒石酸美托洛尔片25 mg,po,bid+单硝酸异山梨酯片40 mg, po,qd+呋塞米片20 mg,po,bid;观察组患者在对照组基础上加用奥美沙坦酯片20 mg,po,qd。两组患者均连续治疗8周。观察两组患者治疗前后心功能指标[左室舒张末期内径(LVEDD)、左房内径(LAD)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室射血分数(LVEF)、早期充盈E峰速率/晚期充盈A峰速率(E/A)]、血浆NT-proBNP和血清IL-23水平,并记录不良反应发生情况。结果:治疗前,两组患者心功能指标、血浆NT-proBNP和血清IL-23水平比较,差异均无统计学意义(P>0.05)。治疗后,两组患者LVEDD、LAD、血浆NT-proBNP和血清IL-23水平显著降低,LVEF和E/A水平显著升高,且观察组显著优于对照组,差异均有统计学意义(P<0.05)。两组患者IVST和LVPWT水平与治疗前比较,观察组患者的不良反应发生率(25.00%)与对照组(20.00%)比较,差异均无统计学意义(P>0.05)。结论:奥美沙坦酯可降低CHF患者血浆NT-proBNP和血清IL-23水平,改善心功能,且安全性较高。
ABSTRACT: OBJECTIVE: To investigate the effects of olmesartan medoxomil on cardiac function, plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) and serum interleukin-23 (IL-23) in patients with chronic heart failure (CHF), and to evaluation its safety. METHODS: A total of 40 CHF patients selected from Lianshui County People’s Hospital of Jiangsu Province during Dec. 2014-May 2016 were divided into control group and observation group according to random number table, with 20 cases in each group. Control group was given Enalapril maleate tablets with initial dose of 5 mg, po, qd (increasing gradually after one week, limiting dose of 20 mg/d)+Metoprolol tartrate tablets 25 mg, po, bid+Isosorbide mononitrate tablets 40 mg, po, qd+Furosemide tablets 20 mg, po, bid. Observation group was additionally given Olmesartan medoxomil tablets 20 mg, po, qd, on the basis of control group. Both groups received treatment for consecutive 8 weeks. Cardiac function indexes [LVEDD, LAD, IVST, LVPWT, LVEF, early diastolic peak E filling velocity/late diastolic peak A filling velocity (E/A)], plasma NT-proBNP and serum IL-23 levels were observed in 2 groups before and after treatment. The incidence of ADR was recorded. RESULTS: Before treatment, there was no statistical significance in cardiac function indexes, plasma NT-proBNP or serum IL-23 levels between 2 groups (P>0.05). After treatment, LVEDD, LAD, plasma NT-proBNP and serum IL-23 levels of 2 groups were decreased significantly, while LVEF and E/A levels were increased significantly; the observation group was significantly better than control group, with statistical significance (P<0.05). There was no statistical significance in IVST or LVPWT levels between 2 groups before and after treatment, and there was no statistical significance in the incidence of ADR between observation group (25.00%) and control group (20.00%)(P>0.05). CONCLUSIONS: Olmesartan medoxomil can decrease the levels of plasma NT-proBNP and serum IL-23 in CHF patients, and improve cardiac function with good safety.
期刊: 2017年第28卷第29期
作者: 周素芹,童嘉毅,朱从飞,李亚伟,周兰兰
AUTHORS: ZHOU Suqin,TONG Jiayi,ZHU Congfei,LI Yawei,ZHOU Lanlan
关键字: 奥美沙坦酯;慢性心力衰竭;心功能;N端脑钠肽前体;白细胞介素23
KEYWORDS: Olmesartan medoxomil; Chronic heart failure; Cardiac function; N-terminal pro-brain natriuretic peptide; Interleukin-23
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