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目的观察前列地尔治疗缺血性心肌病的效果。方法选择2015年6月—2016年10月收治的缺血性心肌病患者96例,随机分为观察组与对照组,每组各48例。两组给予常规药物治疗,观察组在此基础上加前列地尔10μg加入生理盐水10 ml缓慢静脉滴注,1次/d。两组均治疗14 d。治疗前及治疗第7、14天检测两组血浆B型脑钠肽(brain natriuretic peptide,BNP)水平。采用心脏彩色多普勒超声心动图测量左心室射血分数(left ventricular ejection fraction,LVEF)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD),左心室收缩末期内径(left ventricular end-systolic diameter,LVESD),左心室舒张早晚期最大血流速度比值(E/A)。测定6 min步行距离。BNP、心功能指标及6 min步行距离比较采用t检验或重复测量方差分析,P<0.05为差异有统计学意义。结果与治疗前比较,治疗第7、14天两组血浆BNP水平均降低,比较差异有统计学意义(均P<0.05);治疗第7、14天观察组血浆BNP[(465±170)、(357±104)pg/ml]水平低于对照组[(580±159)、(431±146)pg/ml],比较差异有统计学意义(均P<0.05)。与治疗前比较,治疗后两组心功能指标LVEF、LVEDV、LVESV、E/A均改善,比较差异有统计学意义(均P<0.05);治疗后观察组LVEF、LVEDV、LVESV、E/A[(47.06±5.93)%、(131.52±22.76)、(65.48±17.66)mm、1.36±0.21]与对照组[(41.92±6.07)%、(141.61±33.74)、(81.59±15.72)mm、1.18±0.30]比较改善更明显(均P<0.05)。与治疗前比较,治疗第7、14天两组6min步行距离均延长,比较差异有统计学意义(均P<0.05);治疗第7、14天观察组6 min步行距离[(369±56)、(441±60)m]长于对照组[(337±55)、(400±58)m],比较差异有统计学意义(均P<0.05)。结论前列地尔可改善缺血性心肌病患者的心功能。
Objective To observe the effect of alprostadil on ischemic cardiomyopathy. Methods 96 patients with ischemic cardiomyopathy who were admitted from June 2015 to October 2016 were randomly divided into observation group and control group with 48 cases in each group. The two groups were given conventional drug treatment. On the basis of the above, 10 g of alprostadil plus 10 ml of normal saline were given to the observation group by slow intravenous drip once a day. Both groups were treated for 14 days. Before treatment and on the 7th and 14th day of treatment, the levels of plasma B natriuretic peptide (BNP) were measured. Left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD) and left ventricular end-diastolic diameter (LVEDD) were measured by color Doppler echocardiography. systolic diameter, LVESD), and the ratio of the maximal blood flow velocity in early and late diastole of left ventricle (E / A). Determination of 6 min walking distance. BNP, cardiac function and walking distance 6 min comparison using t test or repeated measures analysis of variance, P <0.05 for the difference was statistically significant. Results Compared with those before treatment, plasma BNP levels in both groups decreased on the 7th and 14th day after treatment (all P <0.05); BNP [(465 ± 170), (357 ± 104) pg / ml] were significantly lower than those in the control group [(580 ± 159) and (431 ± 146) pg / ml], respectively. Compared with those before treatment, LVEF, LVEDV, LVESV and E / A in both groups were improved after treatment, and the difference was statistically significant (all P <0.05). After treatment, LVEF, LVEDV, LVESV, E / A [(47.06 ± 5.93)%, (131.52 ± 22.76), (65.48 ± 17.66) mm, 1.36 ± 0.21] and control group (41.92 ± 6.07)%, (141.61 ± 33.74), (81.59 ± 15.72) mm, ± 0.30] compared with the more obvious improvement (all P <0.05). Compared with those before treatment, the walking distance of both groups at 6th and 7th days after treatment was longer than that at 6th minute (all P <0.05). On the 7th and 14th days after treatment, the walking distance at 6 minutes [(369 ± 56) (441 ± 60) m] were longer than those in the control group [(337 ± 55) and (400 ± 58) m], respectively, with significant difference (all P <0.05). Conclusion Alprostadil improves cardiac function in patients with ischemic cardiomyopathy.