【作者】 张明；

【导师】 蔡尚郎；

【作者基本信息】 青岛大学 ， 内学科， 2014， 硕士

【摘要】 目的：动态观察前列地尔对缺血性心肌病患者新功能及血浆脑钠肽(BNP)的影响。方法：选取缺血性心肌病患者60例,随机分为对照组30例和治疗组30例。对照组给予常规抗缺血性心肌病药物[阿司匹林、硝酸酯类、利尿剂、血管紧张素转化酶抑制剂(ACEI).血管紧张素受体阻断剂(ARB)及β受体阻滞剂等]治疗,治疗组在对照组基础上加用前列地尔脂微球载体制剂10ug/d,共14天。观察治疗前后7天,14天各组患者血浆BNP水平,左室射血分数(LVEF)及6分钟步行距离的变化。结果：前列地尔对缺血性心肌病患者血浆BNP水平的影响观察结果显示：两组患者治疗前血浆BNP水平无明显差异。治疗7、14天后对照组患者血浆BNP水平[(594±174)vs(682±231)、(429±135)vs(682±231),p<0.05]与前列地尔组患者血浆BNP水平[(589±155)vs(697±217)、(362±125)vs(697±217),p<0.05]均较治疗前显著降低；同一时间点与对照组比较,结果显示：前列地尔组降低血浆BNP水平的疗效优于对照组,差异有统计学意(P<0.05)。前列地尔对缺血性心肌病患者心功能的影响观察结果显示：两组患者治疗前心功能无明显差异,治疗7、14天后对照组患者左室射血分数[(40.5±5.1)vs(32.2±5.7)、(46.4±5.9)vs(32.2±5.7),p<0.05]与前列地尔组患者左室射血分数[(45.4±4.3)vs(34.5±4.9)、(50.3±5.1)vs(34.5±4.9),p<0.05]；同一时间点前列地尔组与对照组比较,结果显示：前列地尔组改善患者心功能的疗效优于对照组,差异有统计学意(P<0.05)。前列地尔对缺血性心肌病患者6分钟步行距离的影响观察结果显示：两组患者治疗前6分钟步行距离无明显差异,治疗7、14天后对照组患者步行距离[(357±89)vs(156±44)、(451±103)vs(156±44),p<0.05]与前列地尔组患者步行距离[(389±96)vs(164±49)、(496±98)vs(164±49),p<0.05]均较治疗明显延长(P<0.05)；同一时间点与对照组比较,结果显示：前列地尔延长6分钟步行距离的疗效优于对照组,差异有统计学意(P<0.05)。两组均未发生不良反应。结论：在治疗缺血性心肌病时,常规抗血小板、抗凝、扩血管、改善心肌重构等治疗可使病人血浆BNP水平降低、心功能改善,但在此基础上加用前列地尔能更有效的改善心功能,改善病人预后。更多还原

【Abstract】 Objective: To observe the effect of PGE1on the serum levels of BNP and left ventricular function in ischemic cardiomyopathy patients.Methods:60patients with ischemic cardiomyopathy were randomly divided into two groups,30patients for control group and30patients for treatment group. The control group was given conventional treatment of ischemic cardiomyopathy and the treatment group was given additional PGE110ug intravenously for14days. The differences of the serum BNP level, echocardiography and6-minute walking distance before and after treatment between the two groups.Results: The effects of prostaglandin E1on ischemic cardiomyopathy showed that no obvious difference was found between two groups before treatment in ischemic cardiomyopathy patients. After7and14days treatment, both in the control group and in the PGE1group the plasma BNP level was significantly lower than those before therapy (p<0.05), Compared with the control group, at the same point in time, the plasma BNP level was reduced (P<0.05). Beside, we also find that both in the control group and in the PGE1group The cardiac fuction in echocardiography was improved than those before therapy after7and14days treatment(p<0.05). Compared with control group, the LVEF was significantly higher in PGE1group at the same point in time(P<0.05). Also, after7and14days treatment, both in the control group and in the PGE1group6-minute walking distance was prolonged significantly than those before therapy(p<0.05). Compared with the control group,6-minute walking distance was prolonged significantly in PGE1group (P<0.05).The two groups had no adverse reactions at the same point in time.Conclusion: PGE1can further improve cardiac function of patients with ischemic cardiomyopathy..更多还原