心脉隆联合比索洛尔对冠心病心力衰竭患者血清TGF-β及ICAM-1表达的影响

Effects of Xinmailong Combined with Bisoprolol on Serum TGF-β and ICAM-1 Expression in Coronary Heart Disease Patients with Heart Failure

关键词:  心脉隆  比索洛尔  冠心病心力衰竭  转化生长因子-β  细胞间黏附分子-1

Key words:  Xinmailong  bisoprolol  coronary heart disease with heart failure  TGF-β  ICAM-1

摘要:

目的 探索心脉隆联合比索洛尔对冠心病心力衰竭患者转化生长因子-β（transforming growth factor-β，TGF-β）及血清细胞间黏附分子-1（intercellular cell adhesion molecule-1，ICAM-1）表达的影响。方法 选取笔者所在医院2016年3月-2017年4月收治的102例冠心病合并心力衰竭患者作为研究对象，随机分为观察组和对照组，每组各51例。对照组常规治疗基础上给予富马酸比索洛尔片口服治疗，观察组同时给予心脉隆注射液，治疗10 d后，检测2组患者血清B型尿钠肽（BNP）、血清高敏C反应蛋白（hsCRP）、血管内皮生长因子（VEGF）、TGF-β、ICAM-1水平，评价心脏功能指标，记录并比较治疗中出现的不良反应。结果 治疗后，观察组有效例数（47例，92.2%）显著高于对照组（39例，76.5%）（P<0.05）；2组患者血清BNP、hsCRP水平明显低于治疗前，且观察组明显低于对照组（P<0.05）；2组患者左室舒张末期内径（LVEDD）明显低于治疗前，而左室射血分数（LVEF）、每分钟排血量（CO）、心脏指数（CI）明显高于治疗前（P<0.05），观察组心脏功能改善更加显著（P<0.05）；2组患者血清TGF-β、VEGF水平明显高于治疗前，血清ICAM-1水平明显低于治疗前，且观察组改变更显著（P<0.05）；治疗期间2组患者不良反应差异无统计学意义。结论 心脉隆联合比索洛尔治疗冠心病心力衰竭，可有效提高血清TGF-β水平，降低血清ICAM-1表达，减轻心肌炎症反应，控制心室重构，有效改善心脏功能，且安全性高，值得临床推广。

Abstract:

OBJECTIVE To explore the effect of Xinmailong combined with bisoprolol on the expression of transforming growth factor-β(TGF-β) and serum intercellular cell adhesion molecule-1(ICAM-1) in patients with coronary heart disease and heart failure. METHODS One hundred and two patients with coronary heart disease and heart failure who were admitted to the author's hospital from March 2016 to April 2017 were enrolled and divided into observation group and control group via random number table method, each 51 cases. The control group received oral administration of bisoprolol fumarate tablets on the basis standard care. The observation group was treated with Xinmailong injection intravenously additionally. After 10 d of treatment, serum B-type natriuretic peptide(BNP), serum high-sensitivity C-reactive protein(hsCRP), vascular endothelial growth factor(VEGF), serum TGF-β, ICAM-1 level and cardiac functions were detected, and adverse reactions appeared in treatment were recorded. RESULTS After treatment, effective cases(47 cases, 92.2%) in the observation group was significant higher than control group(39 cases, 76.5%)(P<0.05). Serum BNP, hsCRP levels were significantly lower in the two groups compared with before treatment, and observation group were significantly lower than those in the control group(P<0.05). LVEDD was significantly lower, LVEF, CO and CI were significantly higher compared with before treatment in the two groups(P<0.05). Additionally, observation group present a better cardiac function. Serum TGF-β and VEGF levels were significantly higher and serum ICAM-1 levels were significantly lower in the two groups than before treatment. Observation group displayed better improvement in TGF-β and ICAM-1 compared with control group(P<0.05). The patients with adverse reactions in the two groups showed no significant difference. CONCLUSION In the treatment of coronary heart disease heart failure, Xinmailong combined with bisoxolol can effectively improve the level of serum TGF-β, reduce the expression of serum ICAM-1, reduce myocardial inflammatory reaction, control ventricular remodeling, and effectively improve cardiac function with high safety.