非那雄胺对合并前列腺增生的老年慢性心力衰竭心室重构及心功能影响
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- 英文论文题名：The effect of finasteride on left ventricular remodeling and cardiac function in elderly patient with chronic heart failure complicated with benign prostatic hyperplasia
- 论文作者：罗文利 ; 严治涛 ; 柳达 ; 丁海峰 ; 李诗洋
- 英文论文作者：LUO Wen-li ; Yan Zhi-tao ; Liu Da ; Ding Hai-feng ; Li Shi-yang ; Department of Geriatrics ; the First Affiliated Hospital of the Medical College of Shihezi University
- 年：2016
- 作者机构：石河子大学医学院第一附属医院老年病科;石河子大学医学院第一附属医院心血管内科;
- 论文关键词：非那雄胺 ; 心力衰竭 ; 前列腺增生
- 英文论文关键词：finasteride ; heart failure ; benign prostatic hyperplasia
- 会议召开时间：2016-12-01
- 会议录名称：中国医师进修论文选编
- 语种：中文
- 分类号：R697.3;R541.6
- 学会代码：BCLK
- 会议名称：2016年12月中国医师进修学术交流会
- 会议地点：中国北京
- 主办单位：中国医师进修编委会
- 学会名称：百川利康（北京）国际医学研究院
- 页数：4
- 文件大小：665k
- 原文格式：D
- 会议级别：全国
摘要
目的探讨非那雄胺对合并前列腺增生的老年慢性心力衰竭心室重构及心功能的影响。方法选择2011年1月至2014年10月期间在我科及心血管内科住院的老年慢性心力衰竭合并良性前列腺增生患者80例,所有入选者均接受心衰的最佳药物治疗,心力衰竭临床表现均稳定。良性前列腺增生由泌尿外科专门的医生诊治,根据病人症状及实验室检查决定是否使用非那雄胺。使用非那雄胺组为治疗组40例,未使用非那雄胺组为对照组40例。治疗组加用非那雄胺片每次5mg(1片),每天1次,疗程1年。两组治疗前后行超声心动图检查,测量并计算左室舒张末期内径(LVEDd)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、每分钟输出量(CO)、左室短轴缩短率(FS)及射血分数(EF),测定血清氨基末端脑钠肽前体(NT-proBNP)水平。比较组内治疗前后上述指标的变化和组间差异。结果 1.治疗组和对照组治疗1年后,两组心肌重构指标LVEDd、IVST、LVPWT、LVM、LVMI均有明显改善,治疗前后差异有统计学意义(P<0.05),治疗组比对照组改善更明显,组间比较差异有统计学意义(P<0.05)。2.治疗1年后,两组心功能指标CO、FS、EF等均有提高,NT-proBNP水平下降,差异均有统计学意义(P<0.05),治疗组比对照组改善更明显,组间比较差异有统计学意义(P<0.05)。结论对于合并前列腺增生的老年慢性心力衰竭患者,服用非那雄胺可能会改善心室重构及心脏功能。
Objective To explore the effect of finasteride on left ventricular remodeling and cardiac function in elderly patient with chronic heart failure(CHF) complicated with benign prostatic hyperplasia(BPH). Methods Eighty eldly patients with CHF combined with BPH were included in the study. All patients received standard heart failure therapy. The clinical symptoms of heart failure is stable. The treatment of benign prostate hyperplasia is required the use of finasteride is decided by the urologist. According to the use of finasteride were divided into treatment group(n=40) and control group(n=40). The treatment group received finasteride tablet, 5mg(one tablet) a time, one time a day, with a treatment course of 1 year. Echocardiogram was applied to the detection of the left ventricular end-diastolic diameter(LVEDd), interventricular septum diameter(IVST), left ven-tricular posterior diameter(LVPWT), left ventricular myocardial mass(LVM)and left ventricular myocardial mass index(LVMI), left ventricular ejection fraction(LVEF), left ventricular fractional shortening(FS), cardiac output(CO) and serum N-terminal pro-brain natriuretic peptide(NT-pro BNP) level. We compared the changes and differences of the above indexes between the two groups before and after the treatment. Results 1.After 1 year of treatment, LVEDd, IVST, LVWT, LVM and LVMI were obviously improved both in the control group and treatment group. There were significant differences before and after the treatment(P <0.05).After the treatment, They were better improved in the treatment group than in the control group with significant differences(P <0.05). 2. After 1 year of treatment, EF, CO, FS and pro-NTBNP were obviously improved both in the control group and treatment group. There were significant differences before and after the treatment(P <0.05).After the 1 treatment, They were better improved in the treatment group than in the control group with significant differences(P <0.05).Conclusions For parients with CHF combined with BPH taking finasteride may improve cardiac function and left ventricular remodeling.
Objective To explore the effect of finasteride on left ventricular remodeling and cardiac function in elderly patient with chronic heart failure(CHF) complicated with benign prostatic hyperplasia(BPH). Methods Eighty eldly patients with CHF combined with BPH were included in the study. All patients received standard heart failure therapy. The clinical symptoms of heart failure is stable. The treatment of benign prostate hyperplasia is required the use of finasteride is decided by the urologist. According to the use of finasteride were divided into treatment group(n=40) and control group(n=40). The treatment group received finasteride tablet, 5mg(one tablet) a time, one time a day, with a treatment course of 1 year. Echocardiogram was applied to the detection of the left ventricular end-diastolic diameter(LVEDd), interventricular septum diameter(IVST), left ven-tricular posterior diameter(LVPWT), left ventricular myocardial mass(LVM)and left ventricular myocardial mass index(LVMI), left ventricular ejection fraction(LVEF), left ventricular fractional shortening(FS), cardiac output(CO) and serum N-terminal pro-brain natriuretic peptide(NT-pro BNP) level. We compared the changes and differences of the above indexes between the two groups before and after the treatment. Results 1.After 1 year of treatment, LVEDd, IVST, LVWT, LVM and LVMI were obviously improved both in the control group and treatment group. There were significant differences before and after the treatment(P <0.05).After the treatment, They were better improved in the treatment group than in the control group with significant differences(P <0.05). 2. After 1 year of treatment, EF, CO, FS and pro-NTBNP were obviously improved both in the control group and treatment group. There were significant differences before and after the treatment(P <0.05).After the 1 treatment, They were better improved in the treatment group than in the control group with significant differences(P <0.05).Conclusions For parients with CHF combined with BPH taking finasteride may improve cardiac function and left ventricular remodeling.
引文
[1]韩天然,金玉华.良性前列腺增生症与心血管疾病发病机制的相关性[J].中国老年学杂志,2010,30(23):3612-3614.
[2]陈倩,李小鹰,李江源等.老年男性心力衰竭患者性激素水平调查及与同龄健康男性的比较[J].中华心血管病杂志,2005,33(6):505-508.
[3]中华医学会心血管病学分会.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志,2007,35(12):1076-1095.
[4]张祥华,王行环,王刚等.良性前列腺增生诊断治疗.中国泌尿外科疾病诊断治疗指南(2009年版)[M].北京:人民卫生出版社,2009:103-119.
[5]王自力,谢良地.左心室心肌质量的测量[J].中华高血压杂志,2008,16(3):271-272.
[6]Francis GS.Pathophysiology of chronic heart failure[J].Am J Med,2001,110(Suppl 7A):S37-46.
[7]Zwadlo C,Borlak J.Dihydrotestosterone--a culprit in left ventricular hypertrophy.Int J Cardiol.2012,155(3):452-456.
[8]郭枫.非那雄胺治疗老年良性前列腺增生合并慢性心力衰竭患者的疗效[J].中华老年学杂志,2013,33(6):2560-2561.
[9]廖伟光,苏海龙,陈协生等.非那雄胺对慢性心力衰竭合并良性前列腺增生老年男性患者的疗效。岭南心血管病杂志2012,18(4):421-424.
[10]李羽,田志洲,刘力源,王志强.非那雄胺联合特拉唑嗪对老年慢性舒张性心力衰竭合并良性前列腺增生症患者的疗效观察,宁夏医学杂志,2013,36(10):922-924.
[11]祝世法.良性前列腺增生药物治疗方法[J].中华老年医学杂志,2010,29(11):882.
[12]Zwadlo C,Schmidtmann E,Szaroszyk M,et al.Anti-Androgenic Therapy with Finasteride Attenuates Cardiac Hypertrophy and Left Ventricular Dysfunction.Circulation.2015,131(12):1071-1081.
[2]陈倩,李小鹰,李江源等.老年男性心力衰竭患者性激素水平调查及与同龄健康男性的比较[J].中华心血管病杂志,2005,33(6):505-508.
[3]中华医学会心血管病学分会.慢性心力衰竭诊断治疗指南[J].中华心血管病杂志,2007,35(12):1076-1095.
[4]张祥华,王行环,王刚等.良性前列腺增生诊断治疗.中国泌尿外科疾病诊断治疗指南(2009年版)[M].北京:人民卫生出版社,2009:103-119.
[5]王自力,谢良地.左心室心肌质量的测量[J].中华高血压杂志,2008,16(3):271-272.
[6]Francis GS.Pathophysiology of chronic heart failure[J].Am J Med,2001,110(Suppl 7A):S37-46.
[7]Zwadlo C,Borlak J.Dihydrotestosterone--a culprit in left ventricular hypertrophy.Int J Cardiol.2012,155(3):452-456.
[8]郭枫.非那雄胺治疗老年良性前列腺增生合并慢性心力衰竭患者的疗效[J].中华老年学杂志,2013,33(6):2560-2561.
[9]廖伟光,苏海龙,陈协生等.非那雄胺对慢性心力衰竭合并良性前列腺增生老年男性患者的疗效。岭南心血管病杂志2012,18(4):421-424.
[10]李羽,田志洲,刘力源,王志强.非那雄胺联合特拉唑嗪对老年慢性舒张性心力衰竭合并良性前列腺增生症患者的疗效观察,宁夏医学杂志,2013,36(10):922-924.
[11]祝世法.良性前列腺增生药物治疗方法[J].中华老年医学杂志,2010,29(11):882.
[12]Zwadlo C,Schmidtmann E,Szaroszyk M,et al.Anti-Androgenic Therapy with Finasteride Attenuates Cardiac Hypertrophy and Left Ventricular Dysfunction.Circulation.2015,131(12):1071-1081.
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