| Objective: To investigate the changes of heart function symptoms, brain natriuretic peptide(BNP) and ventricular structure of senile patients with coronary heart disease chronic heart failure treated by folic acid in combination with vitamin B12. The therapeutic effect was clarified.Methods: The senile patients with chronic heart failure combined with HHCY caused by coronary heart disease admitted in geriatrics department in Central Hospital of Chengde were selected from October 2013 to November 2014. They were randomly divided into control group and experimental group. The patients in control group were treated with conventional drugs(ACEI-enalapril or ARB-irbesartan, β receptor blocker-bisoprolol, diuretic-hydrochlorothiazide). The patients in experimental group were treated with folic acid and vitamin B12 based on conventional drugs. The blood routine, blood glucose, blood lipid, liver and kidney functions, brain natriuretic peptide(BNP), cardiac color ultrasound and other indicators were examined in 4th and 8th week after treatment. The indicators of various indicators were compared in two groups before and after treatment.Results:(1) There was no significant difference in the levels of homocysteine between experimental group and control group before treatment, P>0.05. In the 4th week after,The levels of HCY in control group were decreased,but which had no statistical significance compared with that before treatment, P>0.05.the level of HCY were decreased in experimental group, which had statistical significance compared with that before treatment, P<0.05. the level of HCY in experimental group was significantly lower than that of control group,which had statistical significance, P<0.05.In the 8th week after,The levels of HCY in control group were decreased,but which had no statistical significance compared with that before treatment, P>0.05.the level of HCY were decreased in experimental group, which had statistical significance compared with that before treatment, P<0.05.And which had statistically significant between experimental group and control group,P<0.05.(2) The levels of N-terminal brain natriuretic peptide showed no statistical difference between experimental group and control group before treatment, P>0.05. In the 4th week after routine treatment or folic acid treatment, the levels of N-terminal brain natriuretic peptide were decreased in two groups, which had statistical significance compared with that before treatment, P<0.05. In the 8th week after conventional treatment or folic acid treatment, the levels of N-terminal brain natriuretic peptide were decreased in two groups, which had statistical significance compared with that before treatment, P<0.05. In the fourth week after treatment, the level of amino-terminal brain natriuretic peptide in experimental group was significantly lower than that of control group, which had statistical significance, P<0.05. In the 8th week after treatment, the levels of N-terminal brain natriuretic peptide in experimental group and control group were decreased than those of the 4th week after treatment, which the difference had statistical significance. P<0.05; And which had statistically significant between experimental group and control group, P<0.05.(3) The ventricular morphology, systolic and diastolic function showed no statistical significance between experiment group and control group before treatment(P>0.05). After treatment for 4 weeks, ventricular morphology, systolic and diastolic functions had no obvious changed in two groups, which had no statistical significance compared with that before treatment, P>0.05. And which had statistically significant between experimental group and control group,which had no statistical significance P>0.05.After treatment for 8 weeks, the ventricular morphology, systolic functions had no change in two groups, which had no statistical significance compared with that before treatment, P>0.05. But after treatment for 8 weeks, the diastolic function of experimental group had improved,which had statistical significance compared with that before treatment, P<0.05.And which had statistically significant between experimental group and control group,P<0.05.Conclusion: After treatment by folic acid in combination with vitamin B12, the levels of HCY, NT-pro BNP, diastolic functions in patients with coronary heart disease chronic heart failure combined with homocystinemia were improved. The effect was better than that of traditional routine medication. |
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