氯沙坦钾联合比索洛尔对慢性心衰患者心功能及外周血内皮祖细胞的影响

目的:探讨氯沙坦钾联合富马酸比索洛尔对慢性心力衰竭(CHF)患者心功能及外周血内皮祖细胞(EPCs)的影响。方法:我院CHF患者110例被随机分为氯沙坦钾组(55例,常规治疗基础上采用氯沙坦钾)和联合治疗组(55例,在氯沙坦钾组基础上加用富马酸比索洛尔),均治疗3个月。统计两组临床疗效、治疗前后血清心型脂肪酸结合蛋白(H-FABP)、氨基末端脑钠肽前体(NT-proBNP)、基质金属蛋白酶抑制剂-1 (TIMP-1)水平、外周血EPCs数目、心功能指标水平及不良反应发生率。结果:联合治疗组总有效率显著高于氯沙坦钾组(94.55%比78.18%,P=0.012);治疗后,与氯沙坦钾组比较,联合治疗组血清TIMP-1 [(3.78±0.48)μg/L比(4.55±0.50)μg/L]水平显著升高,H-FABP [(1925.13±125.17)pg/ml比(1265.25±118.18)pg/ml]及NT-proBNP[(1763.08±197.41)pg/ml比(1017.59±181.28)pg/ml]水平显著降低,外周血EPCs[(3.07±0.83)个/μl比(3.61±0.79)个/μl]数目显著增加,心脏指数(CI)[(2.33±0.46)L·min-1·m-2比(3.21±0.58)L·min-1·m-2],LVEF [(46.58±9.43)%比(59.18±10.02)%],每搏输出量(SV)[(4.11±0.40)L/min比(5.18±0.53)L/min]水平显著提高(P均<0.01);两组不良反应发生率无显著差异(P=0.340)。结论:氯沙坦钾联合富马酸比索洛尔治疗CHF患者,可安全地显著增加外周血EPCs数目,显著改善心功能。

Influence of losartan potassium combined bisoprolol on cardiac function and peripheral blood endothelial progenitor cells in patients with chronic heart failure

Objective:To explore influence of losartan potassium combined bisoprolol fumarate on cardiac function and peripheral blood endothelial progenitor cells(EPCs)in patients with chronic heart failure(CHF).Methods:A total of 110 CHF patients in our hospital were randomly and equally divided into losartan potassium group(received losartan potassium based on routine treatment)and combined treatment group(received bisoprolol fumarate based on losartan potassium group),both groups were treated for three months.Therapeutic effect,serum levels of heart type fatty acid binding protein(H-FABP),N terminal pro brain natriuretic peptide(NT-proBNP),tissue inhibitor of metalloproteinases(TIMP)-1,number of peripheral blood EPCs,cardiac function indexes before and after treatment and incidence rate of adverse reactions were compared between two groups.Results:Total effective rate of combined treatment group was significantly higher than that of losartan potassium group(94.55%vs.78.18%,P=0.012);compared with losartan potassium group after treatment,there were significant reductions in serum levels of H-FABP [(1925.13±125.17)pg/ml vs.(1265.25±118.18)pg/ml]and NT-proBNP[(1763.08±197.41)pg/ml vs.(1017.59±181.28)pg/ml],and significant rise in serum TIMP-1 level[(3.78±0.48)μg/L vs.(4.55±0.50)μg/L],number of peripheral blood EPCs[(3.07±0.83)/μl vs.(3.61±0.79)/μl],cardiac index(CI)[(2.33±0.46)L·min-1·m-2 vs.(3.21±0.58)L·min-1·m-2],LVEF [(46.58±9.43)% vs.(59.18±10.02)%],and stroke volume(SV) [(4.11±0.40)L/min vs.(5.18±0.53)L/min]in combined treatment group,P<0.01 all.There was no significant difference in incidence rate of adverse reactions between two groups,P=0.340.Conclusion:Losartan potassium combined bisoprolol fumarate can significantly increase number of peripheral blood EPCs,improve cardiac function,and it doesn′t increase risk of adverse reactions in CHF patients.