目的探讨真武汤加减联合硝普钠治疗慢性肺源性心脏病(CPHD)急性左心衰竭(ALVF)的疗效及对血脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)水平的影响。方法将80例CPHD后ALVF患者随机分为观察组与对照组各40例。2组入院后均予以常规治疗,对照组应...目的探讨真武汤加减联合硝普钠治疗慢性肺源性心脏病(CPHD)急性左心衰竭(ALVF)的疗效及对血脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)水平的影响。方法将80例CPHD后ALVF患者随机分为观察组与对照组各40例。2组入院后均予以常规治疗,对照组应用硝普钠50 mg+50 m L 0.9%氯化钠溶液微量静脉泵注,观察组在对照组基础上加用真武汤加减治疗,疗程2周。观察2组治疗前后中医证候评分、心脏超声指标、血气指标、肺功能指标以及血浆BNP、hs-CRP水平的变化,比较2组治疗效果。结果观察组中医证候及心功能总有效率显著高于对照组(P均<0.05);治疗后2组的中医证候评分和血浆BNP、hsCRP水平均显著降低(P均<0.05),且观察组显著低于对照组(P均<0.05);治疗后2组肺功能指标(FEV1%、FVC%、FEV1/FVC)、心功能指标(CO、CI、LVEF)、p(O_2)均显著提高(P均<0.05),p(CO2)、LVEDd及LVESd均显著降低(P均<0.05),观察组上述指标改善程度明显优于对照组(P均<0.05)。结论真武汤加减联合硝普钠治疗CPHD后ALVF能够下调外周血hs-CRP及BNP水平,改善心肺功能及临床症状,提高临床疗效。展开更多
Background： The primary cause of ischemic heart failure （HF） is myocardial infarction （MI） resulting in left ventricle （LV） wall motion abnormality secondary to ventricular remodeling. A prospective, nonrandomi...Background： The primary cause of ischemic heart failure （HF） is myocardial infarction （MI） resulting in left ventricle （LV） wall motion abnormality secondary to ventricular remodeling. A prospective, nonrandomized study conducted in China was designed to assess safety and efficacy of the percutaneous ventricular restoration therapy using Parachute device （CardioKinetix, lnc., CA, USA） in ischemic HF patients as a result of LV remodeling after anterior wall M1. Methods： Thirty-one patients with New York Heart Association （NYHA） Class I1, I11 ischemic HF, ejection traction between 15% and 40%, and dilated akinetic or dyskinetic anterior-apical wall without the need to be revascularized were enrolled from seven sites in China from October to December 2014. The Parachute device was implanted through femoral artery. All patients received low-dose aspirin and anticoagulation with warfarin tbr at least 12 months postdevice implantation. The primary end-point was the assessment of efficacy as measured by the reduction in LV end-systolic volume index （LVESVI） against baseline LVESVI at 3 months postdevice implantation, determined by the echocardiography and measured by echocardiography core laboratory. Quality of life was assessed using EQ-SD and visual analog scale （VAS）. For quantitative data comparison, paired t-test （normality data） and signed-rank test （abnormality data） were used： application of signed-rank test was tbr the ranked data comparison. Results： A change in LVESVI as measured by echocardiography from the preimplant baseline to 3-month postdevice implantation revealed a statistically significant reduction from 77.5 ~ 20.0 ml/m-＇ to 53,1 ~ 17.0 ml/m-＂ （P 〈 0.0001 ）, The trial met its primary end-point. Of the 31 patients, the procedural success was 96.8%. Overall, NYHA HF class assessment results showed an improvement of more than halfa class at 3 months （P 〈 0.001 ）. Quality of life assessed by the VAS value increased 11.5 points （P 〈 0.01 ）展开更多
文摘目的探讨真武汤加减联合硝普钠治疗慢性肺源性心脏病(CPHD)急性左心衰竭(ALVF)的疗效及对血脑钠肽(BNP)、超敏C反应蛋白(hs-CRP)水平的影响。方法将80例CPHD后ALVF患者随机分为观察组与对照组各40例。2组入院后均予以常规治疗,对照组应用硝普钠50 mg+50 m L 0.9%氯化钠溶液微量静脉泵注,观察组在对照组基础上加用真武汤加减治疗,疗程2周。观察2组治疗前后中医证候评分、心脏超声指标、血气指标、肺功能指标以及血浆BNP、hs-CRP水平的变化,比较2组治疗效果。结果观察组中医证候及心功能总有效率显著高于对照组(P均<0.05);治疗后2组的中医证候评分和血浆BNP、hsCRP水平均显著降低(P均<0.05),且观察组显著低于对照组(P均<0.05);治疗后2组肺功能指标(FEV1%、FVC%、FEV1/FVC)、心功能指标(CO、CI、LVEF)、p(O_2)均显著提高(P均<0.05),p(CO2)、LVEDd及LVESd均显著降低(P均<0.05),观察组上述指标改善程度明显优于对照组(P均<0.05)。结论真武汤加减联合硝普钠治疗CPHD后ALVF能够下调外周血hs-CRP及BNP水平,改善心肺功能及临床症状,提高临床疗效。
文摘Background： The primary cause of ischemic heart failure （HF） is myocardial infarction （MI） resulting in left ventricle （LV） wall motion abnormality secondary to ventricular remodeling. A prospective, nonrandomized study conducted in China was designed to assess safety and efficacy of the percutaneous ventricular restoration therapy using Parachute device （CardioKinetix, lnc., CA, USA） in ischemic HF patients as a result of LV remodeling after anterior wall M1. Methods： Thirty-one patients with New York Heart Association （NYHA） Class I1, I11 ischemic HF, ejection traction between 15% and 40%, and dilated akinetic or dyskinetic anterior-apical wall without the need to be revascularized were enrolled from seven sites in China from October to December 2014. The Parachute device was implanted through femoral artery. All patients received low-dose aspirin and anticoagulation with warfarin tbr at least 12 months postdevice implantation. The primary end-point was the assessment of efficacy as measured by the reduction in LV end-systolic volume index （LVESVI） against baseline LVESVI at 3 months postdevice implantation, determined by the echocardiography and measured by echocardiography core laboratory. Quality of life was assessed using EQ-SD and visual analog scale （VAS）. For quantitative data comparison, paired t-test （normality data） and signed-rank test （abnormality data） were used： application of signed-rank test was tbr the ranked data comparison. Results： A change in LVESVI as measured by echocardiography from the preimplant baseline to 3-month postdevice implantation revealed a statistically significant reduction from 77.5 ~ 20.0 ml/m-＇ to 53,1 ~ 17.0 ml/m-＂ （P 〈 0.0001 ）, The trial met its primary end-point. Of the 31 patients, the procedural success was 96.8%. Overall, NYHA HF class assessment results showed an improvement of more than halfa class at 3 months （P 〈 0.001 ）. Quality of life assessed by the VAS value increased 11.5 points （P 〈 0.01 ）
