摘要目的 探讨美托洛尔联合左卡尼汀对慢性心力衰竭(CHF)患者心功能及血清转化生长因子-β1(TGF-β1)、可溶性细胞间黏附分子-1(sICAM-1)水平变化影响.方法 将93例CHF患者按随机数字表法分组,对照组46例给予美托洛尔治疗,研究组47例给予美托洛尔与左卡尼汀联合治疗,两组均持续治疗28 d.比较两组治疗前后心功能指标[左室射血分数(LVEF)、左室收缩末期内径(LVESD)、左室收缩末容积(LVSDV)、左室舒张末期内径(LVEDD)],比较两组治疗前后血清转化生长因子(TGF-β1)、可溶性细胞黏附分子-1(sICAM-1)水平及生活质量评分,统计两组临床效果及不良反应发生率.结果 两组治疗前LVEF、LVESD、LVEDD、LVSDV比较差异未见统计学意义(P＞0.05);治疗后与对照组比较,研究组LVESD、LVEDD、LVSDV较低,LVEF较高,差异有统计学意义(P＜0.05).两组治疗前血清TGF-β1、sICAM-1水平对比差异未见统计学意义(P＞0.05);治疗后与对照组比较,研究组血清TGF-β1、sICAM-1水平均较低,差异有统计学意义(P＜0.05).经秩和检验,研究组临床效果优于对照组,差异有统计学意义(P＜0.05).研究组不良反应总发生率[17.02％ (8/47)]与对照组[15.22％ (7/46)]比较差异未见统计学意义(P＞0.05).两组治疗前躯体功能、生理功能、睡眠质量、生命活力等生活质量评分比较差异未见统计学意义(P＞0.05),治疗后与对照组比较,研究组躯体功能、生理功能、睡眠质量、生命活力等生活质量评分均较高,差异有统计学意义(P＜0.05).结论 美托洛尔和左卡尼汀联合治疗CHF患者效果显著,可有效改善其心功能及血清TGF-β1、sICAM-1水平,提升患者生活质量,且安全性较高.

abstractsObjective To investigate the effects of metoprolol combined with levocarnitine on cardiac function and serum transforming growth factor-β1 (TGF-β1) and soluble intercellular adhesion molecule-1 (sICAM-1) levels in patients with chronic heart failure (CHF).Methods Ninety-three patients with CHF were randomly divided into two groups:control group (n =46) and study group (n =47),the control group was treated with metoprolol,and the study group was treated with metoprolol and levocaine,the two groups were treated for 28 d.The cardiac function indexes [left ventricular ejection fraction (LVEF),left ventricular end systolic diameter (LVESD),Left ventricular end-systolic volume (LVSDV),left ventricular end-diastolic diameter (LVEDD)],serum TGF-β1,sICAM-1 levels and quality of life scores were compared between the two groups before and after treatment,and the clinical outcomes and the incidences of adverse reactions were compared.Results There were no significant differences in LVEF,LVESD,LVEDD and LVSDV between the two groups before treatment (P ＞ 0.05);after treatment,compared with the control group,the LVESD,LVEDD and LVSDV levels in the study group were significantly lower and LVEF level was significantly higher (P ＜ 0.05).There was no significant difference in the serum TGF-β1 or sICAM-1 levels between the two groups before treatment (P ＞ 0.05),after treatment,the serum TGF-β1 and sICAM-1 levels in the study group were significantly lower than those in the control group (P ＜ 0.05).The clinical effect of the study group was better than that of the control group,the difference was significant (P ＜ 0.05).There was no significant difference in the total incidence of adverse reactions between the study group [(17.02％ (8/47)] and the control group [15.22％ (7/46)] (P ＞ 0.05).There was no significant difference in the physical function,physiological function,sleep quality,vitality or other life quality scores between the two groups before treatment,while after treatment,those indeces in the study group were significantly higher than those in the control group (P ＜ 0.05).Conclusions Metoprolol and levocarnitine combined treatment has significant effect on CHF patients,with can effectively improve the cardiac function and serum TGF-β1,sICAM-1 level,and improve the quality of life of patients,and has higher security.