大株红景天联合前列地尔治疗冠心病心力衰竭的临床研究
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摘要
目的观察大株红景天注射液联合前列地尔注射液治疗冠心病心力衰竭(CHD-HF)的临床疗效及对病人内皮功能、心功能、心肌酶谱水平的影响。方法选取我院2016年10月—2017年7月收治的70例CHD-HF病人,根据随机数表法分为观察组(35例)和对照组(35例),两组均给予常规基础治疗,对照组给予前列地尔注射液治疗,观察组在对照组的基础上给予大株红景天注射液治疗。治疗28 d后,比较两组临床疗效、心功能、心肌酶谱、内皮功能等水平以及不良反应发生率。结果观察组临床总有效率为97.14%,高于对照组的80.00%,差异有统计学意义(P<0.05);治疗28 d后观察组左室射血分数(LVEF)、每搏输出量(SV)、心排血量(CO)和一氧化氮(NO)水平均高于对照组,左室舒张末期内径(LVEDD)、内皮素(ET)、乳酸脱氢酶(LDH)、肌酸激酶同工酶(CK-MB)和天门冬氨酸氨基转移酶(AST)水平均低于对照组,差异均有统计学意义(P<0.05)。治疗期间,观察组不良反应发生率为11.43%(4/35),低于对照组的14.29%(5/35),但差异无统计学意义(P>0.05)。结论大株红景天注射液联合前列地尔注射液治疗CHD-HF疗效显著,能够进一步改善病人的心功能和内皮功能,降低心肌酶谱水平。
Objective To explore the effects of sofren injection and alprostadil injection on endothelial function,cardiac function and myocardial zymogram in patients with coronary heart disease(CHD)-related heart failure(CHD-HF).Methods Seventy patients with CHD-HF in our hospital from October 2016 to July 2017 were randomly divided into two groups:control group(n=35) treated with alprostadil injection,and observation group(n=35) treated with sofren injection and alprostadil injection in the basis of routine treatment for 28 days.The clinical efficacy,cardiac function,myocardial enzymes,endothelial function and the adverse reactions were compared between two groups.Results The total clinical effective rate was 97.14% in observation group,which was significantly higher than that in control group(80.00%,P<0.05).The levels of left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac output(CO) and nitric oxide(NO) in the observation group after treatment for 28 days were higher than those in the control group.The levels of left ventricular end diastolic diameter(LVEDD),endothelin(ET),lactate dehydrogenase(LDH),creatine kinase isoenzyme MB(CK-MB),and aspartate transaminase(AST) were lower than those of the control group(P<0.05).The incidence of adverse reactions was 11.43% in the observation group,and 14.29% in the control group,there was no significant difference in adverse reactions between two groups(P>0.05).Conclusion Sofren injection and alprostadil injection can further improve the cardiac function and endothelial function,reduce the myocardial zymogram level in patients with CHD-HF.
Objective To explore the effects of sofren injection and alprostadil injection on endothelial function,cardiac function and myocardial zymogram in patients with coronary heart disease(CHD)-related heart failure(CHD-HF).Methods Seventy patients with CHD-HF in our hospital from October 2016 to July 2017 were randomly divided into two groups:control group(n=35) treated with alprostadil injection,and observation group(n=35) treated with sofren injection and alprostadil injection in the basis of routine treatment for 28 days.The clinical efficacy,cardiac function,myocardial enzymes,endothelial function and the adverse reactions were compared between two groups.Results The total clinical effective rate was 97.14% in observation group,which was significantly higher than that in control group(80.00%,P<0.05).The levels of left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac output(CO) and nitric oxide(NO) in the observation group after treatment for 28 days were higher than those in the control group.The levels of left ventricular end diastolic diameter(LVEDD),endothelin(ET),lactate dehydrogenase(LDH),creatine kinase isoenzyme MB(CK-MB),and aspartate transaminase(AST) were lower than those of the control group(P<0.05).The incidence of adverse reactions was 11.43% in the observation group,and 14.29% in the control group,there was no significant difference in adverse reactions between two groups(P>0.05).Conclusion Sofren injection and alprostadil injection can further improve the cardiac function and endothelial function,reduce the myocardial zymogram level in patients with CHD-HF.
引文
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[12] 石惠荣,王德伟,赵丹丹,等.大株红景天注射液治疗缺血性心肌病伴心力衰竭的效果及对血清hsCRP、VEGF的影响[J].河北医科大学学报,2016,37(2):129-132.
[13] 王朝燕,禹露.BNP联合心肌酶谱检测在冠心病危险分层和冠脉搭桥术疗效中预测作用[J].河北医学,2016,22(3):374-378.
[14] 卫娜,李俊男,任俊峰,等.冠心病患者血浆TNF-α与CK-MB、LDH、cTnI水平及冠脉病变的相关性分析[J].中西医结合心脑血管病杂志,2012,10(4):396-398.
[15] 黄洁,王德伟,石惠荣,等.前列地尔改善冠心病患者心肌微循环及血液流变学的疗效分析[J].心血管康复医学杂志,2017,26(2):199-202.
[2] MUNTNER P,WHITTLE J,LYNCH A I,et al.Visit-to-visit variability of blood pressure and coronary heart disease,stroke,heart failure,and mortality:a cohort study[J].Ann Intern Med,2015,163(5):329-338.
[3] 宋振民,蒋陆霞,祁学文.前列地尔治疗左室射血分数正常心力衰竭的临床观察[J].中国药房,2016,27(35):4990-4992.
[4] 林冬群,李丹钗.前列地尔联合大株红景天注射液治疗冠心病心力衰竭的临床疗效分析[J].基层医学论坛,2015(4):502-503.
[5] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014[J].中华心血管病杂志,2014,42(2):98-122.
[6] COLE G D,DHUTIA N M,SHUN-SHIN M J,et al.Defining the real-world reproducibility of visual grading of left ventricular function and visual estimation of left ventricular ejection fraction:impact of image quality,experience and accreditation[J].Int J Cardiovasc Imaging,2015,31(7):1303-1314.
[7] BORER J S,DEEDWANIA P C,KIM J B,et al.Benefits of heart rate slowing with ivabradine in patients with systolic heart failure and coronary artery disease[J].Am J Cardiol,2016,118(12):1948-1953.
[8] 黄国鹏,安素.N末端B型利钠肽原对老年心力衰竭临床应用价值的研究[J].中国循环杂志,2014,29(9):698-701.
[9] 罗明华,关怀敏,解金红,等.光学相干断层成像对支架内再狭窄冠脉内膜病理特点的观察[J].实用医学杂志,2016,32(1):94-97.
[10] 苏陈,吴峰,张帅,等.前列地尔与还原型谷胱甘肽联合应用对冠心病患者PCI术后造影剂肾病的预防作用[J].山东医药,2015,55(31):49-51.
[11] 马岩,黄建立,刘改祥,等.西药联合中药治疗冠心病型心力衰竭的疗效观察[J].中国全科医学,2016,19(12):421-423.
[12] 石惠荣,王德伟,赵丹丹,等.大株红景天注射液治疗缺血性心肌病伴心力衰竭的效果及对血清hsCRP、VEGF的影响[J].河北医科大学学报,2016,37(2):129-132.
[13] 王朝燕,禹露.BNP联合心肌酶谱检测在冠心病危险分层和冠脉搭桥术疗效中预测作用[J].河北医学,2016,22(3):374-378.
[14] 卫娜,李俊男,任俊峰,等.冠心病患者血浆TNF-α与CK-MB、LDH、cTnI水平及冠脉病变的相关性分析[J].中西医结合心脑血管病杂志,2012,10(4):396-398.
[15] 黄洁,王德伟,石惠荣,等.前列地尔改善冠心病患者心肌微循环及血液流变学的疗效分析[J].心血管康复医学杂志,2017,26(2):199-202.