摘要
目的:观察维立西呱辅助常规治疗用于冠心病慢性心力衰竭(CHF)的疗效及对miR-155、miR-214的影响。方法:选取2022年5月至2023年12月该院收治的冠心病CHF患者142例,采用随机数字表法分为对照组(n=71)和观察组(n=71)。对照组患者行常规抗心力衰竭治疗,在此基础上观察组患者加用维立西呱治疗,疗程为3个月。比较两组患者的疗效,治疗前后心功能[左心室射血分数(LVEF)、每搏输出量(SV)和左心室舒张末期内径(LVEDD)]、心血管内皮功能[内皮素-1(ET-1)、一氧化氮(NO)和可溶性细胞间黏附分子-1(sICAM-1)]、心肌微循环、心肌损伤[弗林蛋白酶(Furin)、中性粒细胞/淋巴细胞比值(NLR)和可溶性肿瘤坏死因子样弱凋亡诱导物(sTWEAK)]、miR-155、miR-214等指标水平,以及主要不良心血管事件(MACE)发生率。结果:观察组患者的总有效率为94.37%(67/71),高于对照组的76.06%(54/71),差异有统计学意义(P<0.05)。观察组患者治疗1、3个月后的LVEF、SV、NO和miR-214表达量高于对照组,LVEDD、ET-1、sICAM-1、ST段降低频次、心肌缺血总负荷、NLR、sTWEAK、Furin、miR-155表达量低于对照组,ST段降低持续时间短于对照组,差异均有统计学意义(P<0.05)。随访6个月,观察组患者的MACE发生率为2.82%(2/71),与对照组(9.86%,7/71)比较,差异无统计学意义(P>0.05)。结论:维立西呱辅助治疗可改善冠心病CHF患者的心功能和心血管内皮功能,促进心肌微循环,减轻心肌损伤,调控miR-155、miR-214表达,疗效确切。
OBJECTIVE:To observe the efficacy of vericiguat in assisting conventional treatment of chronic heart failure(CHF)and its effects on miR-155 and miR-214.METHODS:A total of 142 patients with CHF admitted into the hospital from May 2022 to Dec.2023 were extracted to be divided into the control group(n=71)and observation group(n=71)according to the random number table method.The control group received conventional anti-heart failure treatment,while the observation group was given additional treatment with vericiguat.The treatment course was 3 months.The efficacy,cardiac function[left ventricular ejection fraction(LVEF),stroke volume(SV),and left ventricular end-diastolic diameter(LVEDD)],cardiovascular endothelial function[endothelin-1(ET-1),nitric oxide(NO),and soluble intercellular adhesion molecule-1(sICAM-1)],myocardial microcirculation,myocardial injury[Furin,neutrophil/lymphocyte ratio(NLR),and soluble tumor necrosis factor-like apoptosis weak inducer(sTWEAK)],miR-155,miR-214 before and after treatment,and the incidence of major adverse cardiac events(MACE)of two groups was compared.RESULTS:The total effective rate of observation group was 94.37%(67/71),higher than 76.06%(54/71)of the control group,with statistically significant difference(P<0.05).The expression of LVEF,SV,NO,and miR-214 in the observation group was higher than that in the control group after 1 and 3 months of treatment,the expression of LVEDD,ET-1,sICAM-1,ST-segment reduction frequency,total myocardial ischemic load,NLR,sTWEAK,Furin,and miR-155 was lower than that in the control group,and ST-segment reduction duration was shorter than that in the control group,with statistically significant difference(P<0.05).After 6-month follow-up,the incidence of MACE in observation group was 2.82%(2/71),and there was no statistically significant difference compared with the control group(9.86%,7/71)(P>0.05).CONCLUSIONS:The adjunctive treatment with vericiguat can improve the cardiac function and cardiovascular endothelial function in patients with CHF,promote myocardial microcirculation,reduce myocardial injury,regulate the expression of miR-155 and miR-214,with significant efficacy.
作者
王璇
周巧瑞
马国锋
蒋冲
WANG Xuan;ZHOU Qiaorui;MA Guofeng;JIANG Chong(VIP Dept.of Cardiology,Xianyang Hospital of Yan’an University,Shaanxi Xianyang 712000,China;Dept.of Cardiology,Xianyang Hospital of Yan’an University,Shaanxi Xianyang 712000,China;Dept.of CCU,Xianyang Hospital of Yan’an University,Shaanxi Xianyang 712000,China)
出处
《中国医院用药评价与分析》
2025年第8期928-931,937,共5页
Evaluation and Analysis of Drug-use in Hospitals of China
基金
陕西省重点研发计划项目(No.2022SF-1907)。
关键词
冠心病
慢性心力衰竭
心血管内皮功能
维立西呱
主要不良心血管事件
心肌损伤
Coronary heart disease
Chronic heart failure
Cardiovascular endothelial function
Vericiguat
Major adverse cardiac events
Myocardial injury
