| 李 平,李相俊,成小凤,何永铭,李佑美.地高辛联合左西孟旦治疗扩张型心肌病的疗效及对血清HMGB1、sICAM-1、sST2水平的影响[J].,2019,19(19):3657-3660 |
| 地高辛联合左西孟旦治疗扩张型心肌病的疗效及对血清HMGB1、sICAM-1、sST2水平的影响 |
| Curative Efficacy of Digoxin Combined with Levosimendan in the Treatment of Dilated Cardiomyopathy and its Effects on the Serum HMGB1, sICAM-1 and sST2 Levels |
| 投稿时间：2018-12-22 修订日期：2019-01-17 |
| DOI：10.13241/j.cnki.pmb.2019.19.013 |
| 中文关键词: 扩张型心肌病 左西孟旦 地高辛 高迁移率族蛋白B1 可溶性细胞间粘附分子-1 可溶性ST2蛋白 |
| 英文关键词: Dilated cardiomyopathy Levosimendan Digoxin High mobility group protein B1 Soluble intercellular adhesion molecule -1 Soluble ST2 protein |
| 基金项目:全军医学科技青年培育基金项目(15QNP095) |
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| 中文摘要: |
| 摘要 目的：探讨地高辛联合左西孟旦治疗扩张型心肌病的疗效及对血清高迁移率族蛋白B1(HMGB1)、溶性细胞间粘附分子-1(sICAM-1)、可溶性ST2蛋白(sST2)水平的影响。方法：选择2016年2月至2018年2月我院接诊的80例扩张型心肌病患者作为本研究对象，依照随机数表法分为观察组44例和对照组46例，对照组在常规治疗基础上给予左西孟旦治疗，观察组在对照组基础上联合地高辛治疗，两组均连续治疗4周。比较两组的临床疗效、左室射血分数(LVEF)、左室舒张末内径(LVEDD)、血清氨基末端B型钠尿肽前体(NT-proBNP)、HMGB1、sICAM-1、sST2水平的变化及不良反应的发生情况。结果：治疗后，观察组临床疗效总有效率为93.18%(41/44)，明显高于对照组(76.09%，P＜0.05)；观察组LVEF明显高于对照组，LVEDD、血清NT-proBNP水平均明显低于对照组[(46.50±5.21)% vs. (41.20±4.12)%，(54.94±2.29)mm vs. (59.30±2.38)mm，(494.31±75.95)ng/L vs. (589.56±89.40)ng/L](P＜0.05)；观察组血清HMGB1、sICAM-1、sST2水平均明显低于对照组低[(8.42±1.23)pg/mL vs. (13.76±1.70)pg/mL，(122.93±11.03)μg/L vs. (141.58±13.04)μg/L，(0.08±0.02)ng/mL vs. (0.15±0.03)ng/mL](P＜0.05)。治疗期间，两组不良反应发生率分别为9.09%和6.52%，组间差异无统计学意义(P＞0.05)。结论：地高辛联合左西孟旦治疗扩张型心肌病患者的效果显著优于单用左西孟旦治疗，其可更有效降低患者血清HMGB1、sICAM-1、sST2的表达，改善患者心功能，且安全性高。 |
| 英文摘要: |
| ABSTRACT Objective: To study the curative efficacy of digoxin combined with levosimendan in the treatment of dilated cardiomyopathy and its effects on the serum high mobility group protein B1(HMGB1), soluble intercellular adhesion molecule-1(sICAM-1) and soluble ST2 protein(sST2) levels. Methods: 80 patients with dilated cardiomyopathy who were treated from February 2016 to February 2018 in our hospital were selected as research objects, according to the random number table, the patients were divided into 44 cases in the observation group and 46 cases in the control group, the control group was given levosimendan on the basis of routine treatment, while the observation group was given digoxin treatment on the basis of control group, both groups were treated for 4 weeks. The clinical efficacy, the changes of left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD), N-proBNP, HMGB1, sICAM-1 and sST2 before and after treatment and the incidence of adverse reactions were compared between the two groups. Results: After treatment, the total effective rate was 93.18% (41/44) in the observation group, which was significantly higher than 76.09% (35/46) in the control group(P＜0.05); the LVEF of observation group was significantly higher than that of the control group, while the LVEDD and serum N-proBNP level were significantly lower than those of the control group[(46.50±5.21)% vs. (41.20±4.12)%, (54.94±2.29)mm vs. (59.30±2.38)mm, (494.31±75.95)ng/L vs. (589.56±89.40)ng/L](P＜0.05); the serum HMGB1, sICAM-1 and sST2 of observation group were lower than those of the control group[(8.42±1.23)pg/mL vs. (13.76±1.70)pg/ml, (122.93±11.03)μg/L vs. (141.58±13.04)μg/L, (0.08±0.02)ng/mL vs. (0.15±0.03)ng/mL](P＜0.05); during treatment, the incidence of adverse reactions was 9.09% (4/44) and 6.52% (3/46) respectively, and there was no significant difference between the two groups(P>0.05). Conclusion: Digoxin combined with levosimendan is more effective than levosimendan alone in the treatment of dilated cardiomyopathy, which can effectively reduce the serum HMGB1, sICAM-1 and sST2 levels, and significantly improve the cardiac functionwith high safety. |
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