益气复脉注射液联合阿伐他汀治疗冠心病慢性心力衰竭疗效及对sCD40、sCD146、PAPP-A的影响
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摘要
目的:分析益气复脉注射液联合阿伐他汀治疗冠心病慢性心力衰竭患者的疗效及对CD40、CD146、PAPP-A的影响。方法:118例冠心病慢性心力衰竭患者,根据数字表法随机分成两组,每组59例。对照组患者采用阿伐他汀治疗,观察组患者采用益气复脉注射液联合阿伐他汀治疗。观察两组患者治疗前后心功能分级变化;治疗前后LVEF、LVDD、NO、NT-proBNP水平及sCD40、sCD146、PAPP-A水平;用药后不良反应情况。结果:治疗后,观察组患者心功能与对照组相比明显改善,差异有统计学意义(P<0.05);观察组LVEF(40.08±2.86)%、LVDD(51.56±7.19)mm、NT-proBNP水平(1145.17±88.47)pg/mL、sCD40(8.01±2.10)ng/mL、sCD146(184.14±9.63)ng/mL、PAPP-A(2.22±0.72)mU/L明显低于对照组LVEF(46.09±3.93)%、LVDD(57.51±7.90)mm、NT-proBNP水平(1898.53±98.68)pg/mL、sCD40(10.89±2.15)ng/mL、sCD146(190.23±9.21)ng/mL、PAPP-A(3.72±0.80)mU/L,而NO水平(384.21±12.38)μmol/L高于对照组(307.51±13.52)μmol/L,差异有统计学意义(P<0.05)。观察组用药后不良反应发生率(6.78%)明显低于对照组(20.34%),差异有统计学意义(P<0.05)。结论:采用益气复脉注射液联合阿伐他汀治疗冠心病慢性心力衰竭患者效果显著,能有效改善心功能,重塑心室肌,降低sCD40、sCD146、PAPP-A水平,不良反应少,有利于患者预后。
Objective: To analyze the effect of Yiqi Fumai Injection combined with atorvastatin on patients with chronic heart failure of coronary heart disease and the effect on CD40, CD146 and PAPP-A. Methods: A total of 118 patients with CHD were randomly divided into two groups according to the digital table method, with 59 cases in each group. The control group was treated with atorvastatin, while the observation group was treated with Yiqi Fumai Injection combined with atorvastatin. The changes of cardiac function in the two groups were observed before and after treatment, and the levels of LVEF, LVDD, NO, NT-proBNP and sCD40, sCD146 and PAPP-A before and after treatment, and the adverse reactions after treatment. Results: After treatment, the cardiac function of the observation group was significantly improved compared with that of the control group(P<0.05). The observation group's LVEF(40.08±2.86)%, LVDD(51.56±7.19)mm, NT-proBNP(1145.17±88.47)pg/mL, sCD40(8.01±2.10)ng/mL, sCD146(184.14±9.63)ng/mL and PAPP-A(2.22±0.72)mU/L were significantly lower than LVEF(46.09±3.93)%, LVDD(57.51±7.90)mm, NT-proBNP level(1898.53±98.68)pg/mL, sCD40(10.89±2.15)ng/mL, sCD146(190.23±9.21)ng/mL, PAPP-A(3.72±0.80)mU/L of the control group, while the NO level(384.21±9.21) was higher than that of the control group. The difference was statistically significant(P<0.05). The incidence of adverse reactions after treatment in the observation group(6.78%) was significantly lower than that in the control group(20.34%), and the difference was statistically significant(P<0.05). Conclusion: The effect of Yiqi Fumai Injection combined with atorvastatin on patients with chronic heart failure of coronary heart disease is significant. It can effectively improve cardiac function, reshape ventricular muscle and reduce the levels of sCD40, sCD146 and PAPP-A, with less adverse reactions, beneficial to the prognosis of patients.
Objective: To analyze the effect of Yiqi Fumai Injection combined with atorvastatin on patients with chronic heart failure of coronary heart disease and the effect on CD40, CD146 and PAPP-A. Methods: A total of 118 patients with CHD were randomly divided into two groups according to the digital table method, with 59 cases in each group. The control group was treated with atorvastatin, while the observation group was treated with Yiqi Fumai Injection combined with atorvastatin. The changes of cardiac function in the two groups were observed before and after treatment, and the levels of LVEF, LVDD, NO, NT-proBNP and sCD40, sCD146 and PAPP-A before and after treatment, and the adverse reactions after treatment. Results: After treatment, the cardiac function of the observation group was significantly improved compared with that of the control group(P<0.05). The observation group's LVEF(40.08±2.86)%, LVDD(51.56±7.19)mm, NT-proBNP(1145.17±88.47)pg/mL, sCD40(8.01±2.10)ng/mL, sCD146(184.14±9.63)ng/mL and PAPP-A(2.22±0.72)mU/L were significantly lower than LVEF(46.09±3.93)%, LVDD(57.51±7.90)mm, NT-proBNP level(1898.53±98.68)pg/mL, sCD40(10.89±2.15)ng/mL, sCD146(190.23±9.21)ng/mL, PAPP-A(3.72±0.80)mU/L of the control group, while the NO level(384.21±9.21) was higher than that of the control group. The difference was statistically significant(P<0.05). The incidence of adverse reactions after treatment in the observation group(6.78%) was significantly lower than that in the control group(20.34%), and the difference was statistically significant(P<0.05). Conclusion: The effect of Yiqi Fumai Injection combined with atorvastatin on patients with chronic heart failure of coronary heart disease is significant. It can effectively improve cardiac function, reshape ventricular muscle and reduce the levels of sCD40, sCD146 and PAPP-A, with less adverse reactions, beneficial to the prognosis of patients.
引文
[1] 张慧萍,赵国鹏,李俊廷,等.益气复脉注射液与生脉散治疗气阴两虚型慢性心力衰竭临床疗效对比[J].世界中西医结合杂志,2016,11(12):1735-1737,1745.
[2] 韩宇东,张旭光,胡中耀.二丁酰环磷腺苷钙联合丹参川芎嗪注射液治疗慢性心力衰竭的临床观察[J].中西医结合心脑血管病杂志,2017,15(15):1859-1861.
[3] Vaicekavicius E,Vasiliauskas D,Navickas R,et al.Impact of hypertension on postreperfusion left ventricular recovery in patietns with ST-segment elevation myocardial infarction and multivessel coronary artery disease[J].Medicina(Kaunas),2015,51(1):38.
[4] Bourassa MG,Alderman EL,Bertrand M,et al.Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on standardization of clinical nomenclature[J].Circulation,1979,59(2):607-609.
[5] Hunt SA,Abraham WT,Chin MH,et al.ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult[J].Circulation,2005,112 (12):154-235.
[6] Denardo S J,Gong Y,Cooper-DeHoff RM,et al.Effects of Verapamil SR and Atenolol on 24-hour blood pressure and heart rate in hypertension patients with coronary artery disease:an international verapamil SR-tradolapril ambulatory monitoring substudy[J].PloS One,2015,10(4):e0122726.
[7] 陈灏珠.实用内科学[M].12版.北京:人民卫生出版社,2005:1339.
[8] 刘宏颖,张淑平,那雪峰,等.小剂量阿托伐他汀钙片在冠心病心力衰竭患者中的应用效果[J].实用心脑肺血管病杂志,2018,26(2):104-107.
[9] 李红文,关安平,柳莎莎.注射用益气复脉配合西药对难治性终末期心衰患者的疗效观察[J].陕西中医,2016,37(8):989-990.
[10] Klobcar S,Prosen H.Isolation of oxidative degradation products of atorvastatin with supercritical fluid chromatography[J].Biomed Chromatogr,2015,29(12):1901-1906.
[11] 刘慧,李海剑,高传玉,等.PAPP-A的表达及基因多态性与冠心病患者冠状动脉病变程度的关系[J].重庆医学,2016,45(18):2488-2490,2493.
[12] 鞠爱春,罗瑞芝,秦袖平,等.注射用益气复脉(冻干)药理作用及临床研究进展[J].药物评价研究,2018,41(3):354-364.
[13] 石辉进.阿托伐他汀钙对高血压冠心病患者IMT厚度及血脂和心功能的影响[J].河北医药,2018,40(11):1733-1735.
[14] Simmons MA,Brueckner M.The genetics of congenital heart disease understanding and improving long-term outcomes in congenital heart disease:a review for the general cardiologist and primary carephysician[J].Curr Opin Pediatr,2017,29(5):520-528.
[15] 王贤良,马宁,侯雅竹,等.注射用益气复脉(冻干)联合西药常规治疗慢性心力衰竭疗效的Meta分析[J].中医杂志,2016,57(5):391-395.
[16] 周丽,范芳芳,帕提古丽·阿卜杜力,等.益气复脉注射液治疗心力衰竭有效性和安全性的Meta分析[J].中国医药导报,2016,13(22):93-96,104.
[17] Jackowska P,Pytel E,Koter-Michalak M,et al.The effect of combined ezetimibe/atorvastatin therapy vs.atorvastatin monotherapy on the erythrocyte membrane structure in patients with coronary artery disease:a pilot study[J].Adv Clin Exp Med,2016,25(3):433-439.
[18] 连宝涛,李泽彰,陈嘉城,等.益气复脉注射液治疗心力衰竭的系统评价[J].中国实验方剂学杂志,2016,22(8):215-220.
[19] 杨禹娟,张勇,吕军,等.益气复脉注射液治疗老年冠心病并发慢性心力衰竭30例[J].陕西中医,2016,37(10):1325-1326.
[20] 杨丽莉.注射用益气复脉(冻干)粉针对慢性心力衰竭患者心功能及血浆脑钠肽的影响[J].现代中西医结合杂志,2017,26(4):391-393.
[21] 何佳,汪健,胡业彬.益肾活血解毒汤联合调脂药对冠心病合并2型糖尿病患者PAF及CD40/CD40L的影响[J].中国中医急症,2017,26(10):1857-1859.
[22] 文志远,罗友斌,王瑜.益气通脉汤对冠心病心力衰竭患者左心室射血分数、用力肺活量、第1秒钟用力呼气容积及N端脑钠肽前体水平的影响简[J].世界中医药,2018,13(5):1160-1163.
[23] 彭书涛,李辉,陈书存,等.补肺养心汤辅助治疗血瘀阻络型冠心病心力衰竭46例疗效观察[J].四川中医,2018,36(1):84-86.
[2] 韩宇东,张旭光,胡中耀.二丁酰环磷腺苷钙联合丹参川芎嗪注射液治疗慢性心力衰竭的临床观察[J].中西医结合心脑血管病杂志,2017,15(15):1859-1861.
[3] Vaicekavicius E,Vasiliauskas D,Navickas R,et al.Impact of hypertension on postreperfusion left ventricular recovery in patietns with ST-segment elevation myocardial infarction and multivessel coronary artery disease[J].Medicina(Kaunas),2015,51(1):38.
[4] Bourassa MG,Alderman EL,Bertrand M,et al.Report of the Joint International Society and Federation of Cardiology/World Health Organization task force on standardization of clinical nomenclature[J].Circulation,1979,59(2):607-609.
[5] Hunt SA,Abraham WT,Chin MH,et al.ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult[J].Circulation,2005,112 (12):154-235.
[6] Denardo S J,Gong Y,Cooper-DeHoff RM,et al.Effects of Verapamil SR and Atenolol on 24-hour blood pressure and heart rate in hypertension patients with coronary artery disease:an international verapamil SR-tradolapril ambulatory monitoring substudy[J].PloS One,2015,10(4):e0122726.
[7] 陈灏珠.实用内科学[M].12版.北京:人民卫生出版社,2005:1339.
[8] 刘宏颖,张淑平,那雪峰,等.小剂量阿托伐他汀钙片在冠心病心力衰竭患者中的应用效果[J].实用心脑肺血管病杂志,2018,26(2):104-107.
[9] 李红文,关安平,柳莎莎.注射用益气复脉配合西药对难治性终末期心衰患者的疗效观察[J].陕西中医,2016,37(8):989-990.
[10] Klobcar S,Prosen H.Isolation of oxidative degradation products of atorvastatin with supercritical fluid chromatography[J].Biomed Chromatogr,2015,29(12):1901-1906.
[11] 刘慧,李海剑,高传玉,等.PAPP-A的表达及基因多态性与冠心病患者冠状动脉病变程度的关系[J].重庆医学,2016,45(18):2488-2490,2493.
[12] 鞠爱春,罗瑞芝,秦袖平,等.注射用益气复脉(冻干)药理作用及临床研究进展[J].药物评价研究,2018,41(3):354-364.
[13] 石辉进.阿托伐他汀钙对高血压冠心病患者IMT厚度及血脂和心功能的影响[J].河北医药,2018,40(11):1733-1735.
[14] Simmons MA,Brueckner M.The genetics of congenital heart disease understanding and improving long-term outcomes in congenital heart disease:a review for the general cardiologist and primary carephysician[J].Curr Opin Pediatr,2017,29(5):520-528.
[15] 王贤良,马宁,侯雅竹,等.注射用益气复脉(冻干)联合西药常规治疗慢性心力衰竭疗效的Meta分析[J].中医杂志,2016,57(5):391-395.
[16] 周丽,范芳芳,帕提古丽·阿卜杜力,等.益气复脉注射液治疗心力衰竭有效性和安全性的Meta分析[J].中国医药导报,2016,13(22):93-96,104.
[17] Jackowska P,Pytel E,Koter-Michalak M,et al.The effect of combined ezetimibe/atorvastatin therapy vs.atorvastatin monotherapy on the erythrocyte membrane structure in patients with coronary artery disease:a pilot study[J].Adv Clin Exp Med,2016,25(3):433-439.
[18] 连宝涛,李泽彰,陈嘉城,等.益气复脉注射液治疗心力衰竭的系统评价[J].中国实验方剂学杂志,2016,22(8):215-220.
[19] 杨禹娟,张勇,吕军,等.益气复脉注射液治疗老年冠心病并发慢性心力衰竭30例[J].陕西中医,2016,37(10):1325-1326.
[20] 杨丽莉.注射用益气复脉(冻干)粉针对慢性心力衰竭患者心功能及血浆脑钠肽的影响[J].现代中西医结合杂志,2017,26(4):391-393.
[21] 何佳,汪健,胡业彬.益肾活血解毒汤联合调脂药对冠心病合并2型糖尿病患者PAF及CD40/CD40L的影响[J].中国中医急症,2017,26(10):1857-1859.
[22] 文志远,罗友斌,王瑜.益气通脉汤对冠心病心力衰竭患者左心室射血分数、用力肺活量、第1秒钟用力呼气容积及N端脑钠肽前体水平的影响简[J].世界中医药,2018,13(5):1160-1163.
[23] 彭书涛,李辉,陈书存,等.补肺养心汤辅助治疗血瘀阻络型冠心病心力衰竭46例疗效观察[J].四川中医,2018,36(1):84-86.