低分子肝素联合卡维地络对COPD合并心力衰竭患者心肺功能和相关指标的影响

Effects of low molecular weight heparin combined with carvedilol on cardiopulmonary function and related indexes in patients with COPD complicated with heart failure

摘要:

目的探讨低分子肝素联合卡维地络对慢性阻塞性肺疾病(COPD)合并心力衰竭患者心肺功能和相关指标的影响。 方法选择COPD合并心力衰竭患者150例,均分为对照组、肝素组(低分子肝素)和联合组(低分子肝素+卡维地络)。比较治疗前、后各组血清可溶性髓样细胞触发受体-1(sTREM-1)、血清淀粉样蛋白A(SAA)、微小RNA-218(miR-218)及心肺功能,行Pearson相关性分析。 结果治疗后联合组心功能指标、肺功能指标、血气分析指标改善优于其他两组,sTREM-1、SAA和miR-218水平低于其他两组,血清肿瘤坏死因子-α、C反应蛋白和白细胞介素-6水平低于其他两组(P＜0.05)。血清sTREM-1水平与肺功能指标呈负相关(P＜0.05),SAA和miR-218水平与第1秒用力呼气量呈负相关(P＜0.05)。 结论低分子肝素联合卡维地络治疗COPD合并心力衰竭患者,可有效改善患者血清sTREM-1、SAA、miR-218水平及心肺功能,安全性较高,值得推广。

Abstract:

To investigate the effects of low molecular weight heparin combined with carvedilol on cardiopulmonary function and related indexes in patients with chronic obstructive pulmonary disease (COPD) complicated with heart failure. Methods150 patients with COPD complicated with heart failure were divided into control group, heparin group (low molecular weight heparin) and combined group (low molecular weight heparin + carvedilol). Serum soluble myeloid cell trigger receptor-1 (sTREM-1), serum amyloid A (SAA), microrna-218 (miR-218) and cardiopulmonary function were compared before and after treatment, and Pearson correlation analysis was performed. ResultsAfter treatment, the improvement of cardiac function indexes, pulmonary function indexes and blood gas analysis indexes in the combined group were better than those in the other two groups, the levels of sTREM-1, SAA and miR-218 were lower than those in the other two groups, and the serum tumor necrosis factor-α, C-reactive protein and interleukin-6 were lower than those in the other two groups (P＜0.05). The levels of serum sTREM-1 were negatively correlated with lung function index (P＜0.05), and the levels of SAA and miR-218 were negatively correlated with forced expiratory volume in one second (P＜0.05). ConclusionLow molecular weight heparin combined with carvedilol in the treatment of COPD patients with heart failure can effectively improve the serum sTREM-1, SAA, miR-218 and cardiopulmonary function. It is safe and worthy of promotion.