摘要
[背景]观察环磷腺苷葡甲胺(MCA)联合重组人脑利钠肽(rhBNP)和芪苈强心胶囊治疗心力衰竭的疗效.[病例报告]选择心功能Ⅲ级的心力衰竭患者92例,随机分为4个组,即Ⅰ组(常规治疗),Ⅱ组(常规治疗+MCA),Ⅲ组(常规治疗+MCA+rhBNP),Ⅳ组(常规治疗+MCA+rhBNP+芪苈强心胶囊),每组各为23例.Ⅰ,Ⅱ,Ⅲ,Ⅳ组治疗总有效率分别为69.6%,82.6%,87.0%,95.6%,Ⅳ组明显优于Ⅰ组(P<0.05).4个组治疗后每搏输出量(SV)、心输出量(CO)、心脏作功指数(CI)及左心室射血分数(LVEF)较同组治疗前均显著升高(P<0.01).与治疗后Ⅰ组比较,治疗后Ⅱ,Ⅲ,Ⅳ组SV,CO,CI和LVEF均明显升高(P<0.05,P<0.01);与Ⅱ组比较,Ⅲ,Ⅳ组SV,CO,CI和LVEF均明显升高(P<0.05,P<0.01);与Ⅲ组比较,Ⅳ组LVEF明显升高(P<0.05).治疗后Ⅲ,Ⅳ组二尖瓣血流舒张早期最大流动速度与心房收缩期最大流动速度的比值(E/A)较Ⅰ,Ⅱ组均显著升高(P<0.01),Ⅲ,Ⅳ组间差异亦有统计学意义(P<0.01).4个组治疗后BNP水平较同组治疗前均明显降低(P<0.05,P<0.01),Ⅲ,Ⅳ组较Ⅰ组降低更为明显(P<0.05,P<0.01),Ⅳ组与Ⅱ,Ⅲ组比较降低更为明显(P<0.05,P<0.01).[讨论]MCA联合rhBNP和芪苈强心胶囊治疗心力衰竭安全、有效,3者具有协同作用.
BACKGROUNDTo observe the curative effects of meglumine cyclic adenylate（MCA）combined with recombinant human brain natriuretic peptide（rhBNP）and qiliqiangxin capsules（QC）in heart failure patients.CASE REPORTS 92 patients of CHF（NYHY Ⅲ）were randomly divided into 4 groups,groupⅠ（conventional treatment）,groupⅡ（conventional treatment combined with MCA）,groupⅢ（conventional treatment combined with MCA and rhBNP）,and group Ⅳ（conventional treatment combined with MCA,rhBNP and QC）,23 patients in each group.The total effective rates of the four groups were 69.6%,82.6%,87.0% and 95.6% respectively;the total effective rate of the group Ⅳ was significantly higher than it in the group Ⅰ（P〈0.05）.The stroke volume（SV）,cardiac output（CO）,cardiac index（CI）and left ventricle ejection fraction（LVEF）were significantly increased after the treatment in the four groups as compared with them before the treatment（P〈0.01）.After the treatment,the SV,CO,CI and LVEF were significantly increased in groupⅡtoⅣas compared to groupⅠ（P〈0.05,P〈0.01）,the SV,CO,CI and LVEF were significantly increased in group Ⅲ and Ⅳ as compared to group Ⅱ（P〈0.05,P〈0.01）,the LVEF was significantly increased in groupⅣas compared to group Ⅲ（P〈0.05）.After the treatment,the ratio of early diastolic transmitral inflow velocity（E）to late diastolic transmitral inflow velocity（A）（E/A）was significantly increased in group Ⅲ and Ⅳ as compared with groupⅠ and Ⅱ（P〈0.01）,and the differences in groupⅢ and Ⅳ were also statistically significant（P〈0.01）.After the treatment,the plasma levels of BNP were significantly decreased in the four groups as compared with it before the treatment（P〈0.05,P〈0.01）,the plasma levels of BNP were significantly decreased in groupⅢandⅣas compared with group Ⅰ（P〈0.05,P〈0.01）;it decreased obviously in group Ⅳ as compared to group Ⅱ and Ⅲ（P〈0.05,P〈0.01）.DISCUSSION The curative
作者
贾雅楠
关成明
丁虹云
丁大植
JIA Yanan GUAN Chengming DING Hongyun DING Dazhi(Department of Cardiology, Affiliated Hospital of Yanbian University, Yanji 133000, Jilin, China)
出处
《延边大学医学学报》
CAS
2017年第2期120-123,共4页
Journal of Medical Science Yanbian University
基金
吉林省教育厅项目(编号:吉教科合字2015第44号)
关键词
心力衰竭
环磷腺苷葡甲胺
重组人脑利钠肽
芪苈强心胶囊
血流动力学
heart failure
meglumine cyclic adenylate
recombinant human brain natriuretic peptide
qiliqiangxin capsule
hemodynamics
