摘要
目的探讨芪苈强心胶囊辅治扩张型心肌病(DCM)并慢性心力衰竭(CHF)的效果及对神经内分泌因子、炎性因子及心室重构的影响。方法选择2018年11月—2019年10我院心内科收治的DCM合并CHF患者95例,据治疗方法不同分为观察组45例和对照组40例。对照组按指南给予常规治疗,观察组在对照组基础上联合芪苈强心胶囊,2组均治疗4周。比较2组临床疗效,治疗前后左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF),治疗前1 d及治疗结束后首日去甲肾上腺素(NE)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、肿瘤坏死因子-α(TNF-α)、N末端脑钠肽前体(NTpro-BNP)、超敏C反应蛋白(hs-CRP)、基质金属蛋白酶-9(MMP-9)、Ⅰ型前胶原氨基末端肽(PⅠNP)和Ⅲ型前胶原氨基末端肽(PⅢNP)水平。结果观察组总有效率高于对照组(P<0.05)。2组治疗后LVEDD、LVEF均较治疗前明显改善,且观察组改善程度优于对照组(P<0.01)。2组治疗后血清NE、AngⅡ、ALD、TNF-α、NTpro-BNP、hs-CRP水平显著下降,且观察组低于对照组(P<0.01)。2组治疗后血清MMP-9、PⅠNP和PⅢNP水平均低于治疗前,且观察组低于对照组(P<0.05,P<0.01)。结论芪苈强心胶囊辅助治疗可提高DCM合并CHF的疗效,使患者症状明显好转,并可改善其心功能,减少NE、AngⅡ和ALD的产生,抑制炎性因子分泌,减轻心肌损伤,延缓和改善心室重构,从而改善预后。
Objective To investigate the effect of Qiliqiangxin capsule on dilated cardiomyopathy(DCM)with chronic heart failure(CHF)and its effects on neuroendocrine factors,inflammatory factors and ventricular remodeling.Methods From November 2018 to October 2019,95 patients with DCM and CHF were selected and divided into observation group(n=45)and control group(n=40)according to different treatment methods.The control group was given conventional treatment according to the guidelines,and the observation group was supplemented with Qiliqiangxin capsule on the basis of the control group.Both groups were treated for 4 weeks.The clinical efficacy,left ventricular end diastolic diameter(LVEDD)and left ventricular ejection fraction(LVEF)before and after treatment were compared between the two groups.D and on the first day after treatment,norepinephrine(NE),angiotensinⅡ(AngⅡ),aldosterone(ALD),tumor necrosis factor-α(TNF-α),N-terminal pro brain natriuretic peptide(NTpro-BNP),high sensitivity C-reactive protein(hs-CRP),matrix metalloproteinase-9(MMP-9),N-terminal pro collagen peptide(PⅠNP)and N-terminal pro collagen peptide(PⅢNP)were detected at 1 d before treatment and at 1 d after completion of treatment.Results The total effective rate of the observation group was higher than that of the control group(P<0.05).LVEDD and LVEF were significantly improved after treatment,and the indicators were improved more significantly in the observation group than in the control group after treatment(P<0.01).After treatment,the levels of serum NE,AngⅡ,ALD,TNF-α,NTpro-BNP and hs-CRP in the two groups were decreased significantly,and the indicators were lower in the observation group than in the control group(P<0.01).After treatment,the serum levels of MMP-9,PⅠNP and PⅢNP in the two groups were lower than those before treatment,and the levels were lower in the observation group than in the control group(P<0.05,P<0.01).Conclusion Qiliqiangxin capsule can improve the clinical efficacy of DCM patients with CHF,improve their conditio
作者
王艳丽
王艳萍
马金波
王越
李金锋
吕素洁
马宇杰
WANG Yan-li;WANG Yan-ping;MA Jin-bo;WANG Yue;LI Jin-feng;LYU Su-jie;MA Yu-jie(Emergency Intensive Care Unit,b.Cardiology Department,Tangshan,Hebei 063000,China;Emergency Intensive Care Unit,Kailuan General Hospital,Tangshan,Hebei 063000,China;Obstetrics Department,Zunhua People's Hospital,Zunhua,064200 Hebei,China)
出处
《解放军医药杂志》
CAS
2021年第2期84-88,共5页
Medical & Pharmaceutical Journal of Chinese People’s Liberation Army
基金
河北省医学科学研究重点课题计划项目(20181433)。
关键词
扩张型心肌病
心力衰竭
芪苈强心胶囊
心功能
去甲肾上腺素
血管紧张素Ⅱ
心室重构
超敏C反应蛋白
Dilated cardiomyopathy
Heart failure
Qiliqiangxin capsule
Cardiac function
Noradrenaline
AngiotensinⅡ
Ventricular remodeling
Hypersensitive C-reactive protein
