丹参川芎嗪联合NIPPV对老年肺心病患者心肺功能及血清sST2、NT-proBNP的影响
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摘要
目的 研究丹参川芎嗪联合无创正压通气(NIPPV)对老年肺心病患者心肺功能及血清N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)和可溶性人基质裂解素2(soluble suppression of tumorigenesis 2,sST2)影响。方法 选择2015年6月至2017年6月收治的120例老年肺心病患者,根据随机数字表法分为对照组和观察组,每组60例。其中对照组接受NIPPV治疗,观察组联合使用NIPPV和丹参川芎嗪。比较2组患者治疗后的疗效、治疗前后生活质量,心肺功能和血清sST2、NT-proBNP水平以及不良反应情况。结果 观察组治疗总有效率91.67%和中医证候评分有效率(88.33%)均明显高于对照组(78.33%、73.33%),差异有统计学意义(P<0.05)。2组患者治疗后心肺功能指标均显著改善,其中观察的SV、EF、E/A、 FEV1/FVC、 FEV1%指标水平显著高于对照组,EF显著低于对照组(P<0.05)。2组患者治疗后血清sST2、NT-proBNP水平均显著下降,且观察组血清sST2、NT-proBNP水平显著低于对照组(P<0.05)。2组患者经治疗后生理功能、身体疼痛以及总体健康评分均显著增加,其中观察组各评分显著高于对照组(P<0.05)。2组患者治疗期间的不良反应类型和发生率差异无统计学意义(P>0.05)。结论 丹参川芎嗪联合NIPPV治疗肺心病疗效显著,能够有效降低血清sST2、NT-proBNP水平,改善心肺功能,从而促进预后以及提高治疗效果和生活质量,值得推广应用。
Objective To investigate the effects of Danshen Ligustrazine combined with non-invasive positive pressure ventilation(NIPPV) on cardiorespiratory function and serum levels of N-terminal pro-brain natriuretic peptide(NT-proBNP) and soluble suppression of tumorigenesis 2(sST2) in elderly patients with pulmonary heart disease(PHD).Methods A total of 120 elderly patients with PHD who were admitted and treated in our hospital from June 2015 to June 2017 were randomly divided into observation group(n=60) and control group(n=60) according to random digital table. The patients in control group were treated by NIPPV,however,the patients in observation group were treated by NIPPV combined with Danshen Ligustrazine.The clinical curative effects, the quality of life,cardiopulmonary function and serum levels of sST2 and proBNP as well as adverse reactions were observed and compared between the two groups before and after treatment.Results After treatment,the clinical total effective rate(91.67%) and the effective rate of TCM syndrome score(88.33%) in observation group were significantly higher than those(78.33% and 73.33%,respectively) in control group(P<0.05).The indexes of cardiac and pulmonary function were significantly improved after treatment in both groups,and the levels of SV,EF,E/A,FEV1/FVC and FEV1% in observation group were significantly higher than those in control group,however, the EF levels were significantly lower than those in control group(P<0.05).After treatment,the serum levels of sST2 and NT-proBNP were significantly decreased in both groups(P<0.05),moreover, the serum levels of sST2 and NT-proBNP in observation group were significantly lower than those in control group(P<0.05).The physiological function,body pain and overall health scores in both groups were significantly increased after treatment,and the scores in observation group were significantly higher than those in control group(P<0.05).In addition there were no significant differences in the type and incidence rate of adverse reactions between the two groups(P>0.05).Conclusion The therapeutic effects of Danshen Ligustrazine combined with NIPPV on PHD are significantly effective,which can effectively reduce the serum levels of sST2 and NT-proBNP,improve cardiopulmonary function,improve patient's prognosis, therapeutic effects and life quality of patients,thus, which is worth popularizing in clinical practice.
Objective To investigate the effects of Danshen Ligustrazine combined with non-invasive positive pressure ventilation(NIPPV) on cardiorespiratory function and serum levels of N-terminal pro-brain natriuretic peptide(NT-proBNP) and soluble suppression of tumorigenesis 2(sST2) in elderly patients with pulmonary heart disease(PHD).Methods A total of 120 elderly patients with PHD who were admitted and treated in our hospital from June 2015 to June 2017 were randomly divided into observation group(n=60) and control group(n=60) according to random digital table. The patients in control group were treated by NIPPV,however,the patients in observation group were treated by NIPPV combined with Danshen Ligustrazine.The clinical curative effects, the quality of life,cardiopulmonary function and serum levels of sST2 and proBNP as well as adverse reactions were observed and compared between the two groups before and after treatment.Results After treatment,the clinical total effective rate(91.67%) and the effective rate of TCM syndrome score(88.33%) in observation group were significantly higher than those(78.33% and 73.33%,respectively) in control group(P<0.05).The indexes of cardiac and pulmonary function were significantly improved after treatment in both groups,and the levels of SV,EF,E/A,FEV1/FVC and FEV1% in observation group were significantly higher than those in control group,however, the EF levels were significantly lower than those in control group(P<0.05).After treatment,the serum levels of sST2 and NT-proBNP were significantly decreased in both groups(P<0.05),moreover, the serum levels of sST2 and NT-proBNP in observation group were significantly lower than those in control group(P<0.05).The physiological function,body pain and overall health scores in both groups were significantly increased after treatment,and the scores in observation group were significantly higher than those in control group(P<0.05).In addition there were no significant differences in the type and incidence rate of adverse reactions between the two groups(P>0.05).Conclusion The therapeutic effects of Danshen Ligustrazine combined with NIPPV on PHD are significantly effective,which can effectively reduce the serum levels of sST2 and NT-proBNP,improve cardiopulmonary function,improve patient's prognosis, therapeutic effects and life quality of patients,thus, which is worth popularizing in clinical practice.
引文
1 吴宗劲,华海湖,梁旭.无创呼吸机对老年肺心病患者心脏Tei指数、脑钠肽及内皮素-1水平的影响.中国老年学杂志,2014,34:3916-3917.
2 李红建,范建新.无创正压通气联合丹参川芎嗪注射液治疗老年肺心病疗效观察.现代中西医结合杂志,2016,25:2146-2147,2160.
3 田昭涛,李慧丽,崔云亮.无创通气联合硫酸镁对肺心病伴呼吸衰竭患者血浆hs-CRP和NT-proBNP的影响.山东医药,2014,54:45-46.
4 刘烨,李清英,罗绍友.丹参川芎嗪配合无创正压通气治疗老年肺心病的疗效观察.重庆医学,2015,44:1699-1701.
5 林绍侠,刘志兵,蔡铁海,等.血清sST2联合NT-proBNP检测对心力衰竭患者预后的预测价值.山东医药,2016,56:61-62.
6 葛剑力,邵莉,滕丽莉,等.可溶性ST2在急性冠脉综合征患者预后评估中的价值.中国老年学杂志,2014,34:5970-5973.
7 Huang DH,Hao S,Shi JP.Diagnostic Value of Soluble Suppression of Tumorigenicity-2 for Heart Failure.Chin Med J (Engl),2016,129:570-577.
8 郑文,刘新风,王德景.心力衰竭患者血清NT-ProBNP水平变化及意义.山东医药,2015,55:54-55.
9 中华医学会呼吸病学会.慢性肺源性心脏病临床诊断及疗效判定标准.中华结核与呼吸杂志,1980,3:23-25.
10 李家飞,李迅,何文彬.疏风解毒胶囊联合多索茶碱对肺心病患者肺功能与免疫功能的影响研究.北京医学,2017,39:424-426.
11 Ke QM,Wu J,Tian L,et al.Role of Voltage-gated Potassium Channels in Pathogenesis of Chronic Pulmonary Heart Disease.Journal of Huazhong University of Science and Technology (Medical Sciences),2013,33:644-649.
12 Januzzi JL,Pascualfigal D,Daniels LB.ST2 testing for chronic heart failure therapy monitoring:the International ST2 Consensus Panel.American Journal of Cardiology,2015,115:70B-75B.
13 Kov? cs LG,Nyolczas N,Habon T,et al.Measurement of natriuretic peptides in heart failure:the good laboratory and clinical practice.Orv Hetil,2015,156:1235-1245.
14 ?olak A,?uhadar S,G?lcük B,et al.Effect of renal failure on N-terminal Pro-Brain natriuretic peptide in patients admitted to emergency department with acute dyspnea.Anadolu Kardiyol Derg,2014,14:519-524.
15 Radwan H,Selem A,Ghazal K.Value of N-terminal pro brain natriuretic peptide in predicting prognosis and severity of coronary artery disease in acute coronary syndrome.J Saudi Heart Assoc,2014,26:192-198.
2 李红建,范建新.无创正压通气联合丹参川芎嗪注射液治疗老年肺心病疗效观察.现代中西医结合杂志,2016,25:2146-2147,2160.
3 田昭涛,李慧丽,崔云亮.无创通气联合硫酸镁对肺心病伴呼吸衰竭患者血浆hs-CRP和NT-proBNP的影响.山东医药,2014,54:45-46.
4 刘烨,李清英,罗绍友.丹参川芎嗪配合无创正压通气治疗老年肺心病的疗效观察.重庆医学,2015,44:1699-1701.
5 林绍侠,刘志兵,蔡铁海,等.血清sST2联合NT-proBNP检测对心力衰竭患者预后的预测价值.山东医药,2016,56:61-62.
6 葛剑力,邵莉,滕丽莉,等.可溶性ST2在急性冠脉综合征患者预后评估中的价值.中国老年学杂志,2014,34:5970-5973.
7 Huang DH,Hao S,Shi JP.Diagnostic Value of Soluble Suppression of Tumorigenicity-2 for Heart Failure.Chin Med J (Engl),2016,129:570-577.
8 郑文,刘新风,王德景.心力衰竭患者血清NT-ProBNP水平变化及意义.山东医药,2015,55:54-55.
9 中华医学会呼吸病学会.慢性肺源性心脏病临床诊断及疗效判定标准.中华结核与呼吸杂志,1980,3:23-25.
10 李家飞,李迅,何文彬.疏风解毒胶囊联合多索茶碱对肺心病患者肺功能与免疫功能的影响研究.北京医学,2017,39:424-426.
11 Ke QM,Wu J,Tian L,et al.Role of Voltage-gated Potassium Channels in Pathogenesis of Chronic Pulmonary Heart Disease.Journal of Huazhong University of Science and Technology (Medical Sciences),2013,33:644-649.
12 Januzzi JL,Pascualfigal D,Daniels LB.ST2 testing for chronic heart failure therapy monitoring:the International ST2 Consensus Panel.American Journal of Cardiology,2015,115:70B-75B.
13 Kov? cs LG,Nyolczas N,Habon T,et al.Measurement of natriuretic peptides in heart failure:the good laboratory and clinical practice.Orv Hetil,2015,156:1235-1245.
14 ?olak A,?uhadar S,G?lcük B,et al.Effect of renal failure on N-terminal Pro-Brain natriuretic peptide in patients admitted to emergency department with acute dyspnea.Anadolu Kardiyol Derg,2014,14:519-524.
15 Radwan H,Selem A,Ghazal K.Value of N-terminal pro brain natriuretic peptide in predicting prognosis and severity of coronary artery disease in acute coronary syndrome.J Saudi Heart Assoc,2014,26:192-198.