Résumé
Objective:To explore influence of amlodipine besylate tablet combined metoprolol on serum inflammatory factor levels and cardiac function in aged patients with essential hypertension(EH)complicated chronic heart failure(CHF).Methods:A total of 98 aged EH+CHF patients treated in our hospital from Jan 2014 to Oct 2015 were se-lected.Patients were randomly and equally divided into metoprolol group(received metoprolol based on routine treatment)and combined treatment group(received amlodipine besylate tablet based on metoprolol group),both groups were treated for six months.Serum levels of interleukin(IL)-1,IL-6 and tumor necrosis factor(TNF)-α, left ventricular end-diastolic dimension(LVEDd),left ventricular end-systolic dimension(LVESd)and left ventric-ular ejection fraction(LVEF)before and six months after treatment,and therapeutic effect were measured and compared between two groups.Results:Compared with before treatment,after six-month treatment,there were significant reductions in serum levels of IL-1,IL-6,TNF-α,LVEDd and LVESd,and significant rise in LVEF in two groups,P=0.001 all;compared with metoprolol group after six-month treatment,there were significant reduc-tions in serum levels of IL-1[(16.21 ± 1.45)ng/L vs.(12.34 ± 1.32)ng/L],IL-6[(46.21 ± 5.32)ng/L vs. (36.42 ± 4.51)ng/L],TNF-α[(23.12 ± 2.14)ng/L vs.(19.25 ± 2.41)ng/L],LVEDd[(51.68 ± 4.74)mm vs. (42.31 ± 4.25)mm]and LVESd[(46.27 ± 4.78)mm vs.(39.06 ± 4.35)mm],and significant rise in LVEF [(43.26 ± 4.37)% vs.(52.95 ± 5.18)%]in combined treatment group,P=0.001 all.Total effective rate of com-bined treatment group was significantly higher than that of metoprolol group(93.88% vs.79.59%),P= 0.037. There was no significant difference in incidence rate of adverse reactions between two groups,P=0.505. Conclu-sion:Amlodipine besylate combined metoprolol possesses significant therapeutic effect on aged EH + CHF patients, which may reduce serum inflammatory factor levels,relieve ventricular remodeling and improve cardiac function.
Résumé
<p><b>BACKGROUND</b>The percutaneous transcatheter closure of secundum atrial septal defect (ASD) is increasingly a widespread alternative to surgical closure. The aim of this study was to assess long-term results of percutaneous closure of secundum-type atrial septal defect (ASDII).</p><p><b>METHODS</b>Between January 2001 and December 2005, 61 patients underwent a successful percutaneous closure of ASDII; including 25 male and 36 female. All were included in the patient study and were followed up to monitor by electrocardiogram and echocardiography, at intervals of 3 days, 3 months, 6 months, 1 year, 2 years, and 5 years after operation.</p><p><b>RESULTS</b>Three days after percutaneous transcatheter septal closure (PTSC), the right atrium diameter, right ventricular end-diastolic left-right diameter and right ventricular end-diastolic volume (RVEDV) decreased significantly (P < 0.05). Right ventricular end-diastolic anteroposterior diameter (RVEDD), right ventricular end-systolic volume (RVESV) and right ventricular ejection fraction (RVEF) also decreased (P < 0.01). During the period from 3 to 6 months, the size of the right atrium and right ventricle returned to normal range. Three days after PTSC, the left ventricular end-diastolic diameter (LVEDD), left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV), left ventricular-systolic volume (LVSV) and left ventricular ejection fraction (LVEF) were significantly increased (P < 0.05). At 1 year, the size of the left atrium, left ventricle and left cardiac function returned to normal range (P < 0.01). There were no deaths or significant complications during the study. At five year follow-up, all defects were completely closed and remained closed thereafter.</p><p><b>CONCLUSION</b>Transcatheter closure of ASDII effectively eliminated the abnormal shunt and, subsequently improved the dimensions of each chamber and cardiac function.</p>