心脉隆注射液对肺心病并发难治性心力衰竭患者和肽素的影响
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摘要
目的研究心脉隆注射液治疗慢性肺源性心脏病并发难治性心力衰竭患者的临床疗效及对和肽素的影响。方法选择2014年12月至2018年1月收治的慢性肺源性心脏病并发难治性心力衰竭患者82例,随机分为治疗组和对照组,每组41例。对照组给予常规治疗,治疗组在对照组基础上加用心脉隆注射液静脉滴注,连续应用12 d。观察2组患者的临床疗效及6 min步行距离(6-MWT);2组患者治疗前后肺动脉收缩压(PASP)、肺动脉平均压(MPAP)、左心室射血分数(LVEF);检测2组治疗前后NT-proBNP以及和肽素水平。结果治疗组总有效率为92.68%明显高于对照组的78.05%,差异有统计学意义(P<0.05)。治疗前,2组患者肺动脉压、NT-proBNP、和肽素及6-MWT差异均无统计学意义(P>0.05)。治疗后12 d,2组肺动脉压、NT-proBNP、和肽素及6-MWT均有不同程度的改善,治疗组改善程度更加显著(P<0.05)。相关分析显示和肽素与患者病情程度呈正相关关系(r=0.806,P<0.01),即和肽素水平越高,患者病情越重。结论心脉隆能有效改善患者心功能,降低和肽素水平,迅速缓解临床症状,治疗效果显著。
Objective To observe the clinical curative effects of Xinmailong injection on chronic pulmonary heart disease complicated by refractory heart failure and its effects on Copeptin. Methods A total of 82 patients with chronic pulmonary heart disease complicated by refractory heart failure who were admitted and treated in our hospital from December 2014 to January 2018 were randomly divided into treatment group(n=41) and control group(n=41).The patients in control group were given routine therapy, however,the patients in treatment group,on the basis of control group,were treated by intravenous drip of Xinmailong injection for 12 days.The clinical curative effects and 6-minute walking distance were observed. Moreover the pulmonary artery systolic pressure(PASP), mean pulmonary artery pressure(MPAPP), left ventricular ejection fraction(LVEFV), and the levels of NT-proBNP and peptide were detected before and after treatment. Results The total effective rate in treatment group was significantly higher than that in control group(P<0.05).Before treatment, there were no significant differences in pulmonary arterial pressure,NT-proBNPP,Copeptin and 6-MWT between the two groups(P>0.05).At 12 days after treatment, the pulmonary arterial pressure,NT-proBNPP, Copeptin peptide and 6-MWT were improved in both groups to some extent, moreover, the improvement degree in treatment group was more significant than that in control group(P<0.05).Correlation analysis showed that the higher the levels of Copeptin, the more severe the patient's disease condition,there was a positive correlation between them(r=0.806,P<0.01). Conclusion Xinmailong can effectively improve the heart function of patients with chronic pulmonary heart disease complicated by refractory heart failure,which can reduce the levels of Copeptin and relieve clinical symptoms quickly,with obvious therapeutic effects.
Objective To observe the clinical curative effects of Xinmailong injection on chronic pulmonary heart disease complicated by refractory heart failure and its effects on Copeptin. Methods A total of 82 patients with chronic pulmonary heart disease complicated by refractory heart failure who were admitted and treated in our hospital from December 2014 to January 2018 were randomly divided into treatment group(n=41) and control group(n=41).The patients in control group were given routine therapy, however,the patients in treatment group,on the basis of control group,were treated by intravenous drip of Xinmailong injection for 12 days.The clinical curative effects and 6-minute walking distance were observed. Moreover the pulmonary artery systolic pressure(PASP), mean pulmonary artery pressure(MPAPP), left ventricular ejection fraction(LVEFV), and the levels of NT-proBNP and peptide were detected before and after treatment. Results The total effective rate in treatment group was significantly higher than that in control group(P<0.05).Before treatment, there were no significant differences in pulmonary arterial pressure,NT-proBNPP,Copeptin and 6-MWT between the two groups(P>0.05).At 12 days after treatment, the pulmonary arterial pressure,NT-proBNPP, Copeptin peptide and 6-MWT were improved in both groups to some extent, moreover, the improvement degree in treatment group was more significant than that in control group(P<0.05).Correlation analysis showed that the higher the levels of Copeptin, the more severe the patient's disease condition,there was a positive correlation between them(r=0.806,P<0.01). Conclusion Xinmailong can effectively improve the heart function of patients with chronic pulmonary heart disease complicated by refractory heart failure,which can reduce the levels of Copeptin and relieve clinical symptoms quickly,with obvious therapeutic effects.
引文
1 邵琴.丹参川芎嗪注射液对慢性肺心病心衰患者的疗效和预后影响的研究. 中西医结合心血管病杂志,2016,4:150-151.
2 武旭光.西地那非在慢性阻塞性肺疾病治疗中的应用. 基层医学论坛,2016,20: 3755-3756.
3 中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南(2013年修订版).中华结核和呼吸杂志,2013,36:255-264.
4 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.中华心血管病杂志,2014,42:98.
5 初青莲,吴学杰. 氯毗格雷联合低分子肝素钙治疗慢性肺源性心脏病急性加重期的临床应用.中国综合临床,2014,30:238-240.
6 Martin KB,Klinger JR,Rounds SI.Pulmonary arterial hypertension:newi- nsights and New hope.Respirology,2006,11:6.
7 Crosswhite P,Sun Z.Nitric oxide,oxidative stress and inflammation inpu- lmonaryarterial hypertension.J Hypertens,2010,28:201.
8 苏宏.疏血通注射液辅助治疗 AECOPD 合并慢性肺心病心力衰竭的疗效观察.中西医结合心脑血管病杂志,2017,15: 845-846.
9 盛晓生,林丽,丁明星,等.和肽素水平对大鼠心肾综合征的早期预测价值.中国病理生理杂志,2018,34:264-269.
10 Balling L,Gustafsson F.Copeptin in heart failure.Adv Clin Chem,2016,73: 29-64.
11 高枫,韩肖肖,毕云, 等.慢性心衰患者血清 NT-proBNP 和 cTnI 联合检测及临床意义. 陕西医学杂志, 2017,46:325-327.
12 薛金贵,王肖龙,许勇,等.心脉隆注射液治疗慢性心力衰竭(气阳两虚,瘀血内阻证)的多中心随机对照研究.中国中西医结合杂志,2015,35:796-800.
13 张家美,尚亚东,吴晓蓉,等.心脉隆注射液治疗慢性心力衰竭临床疗效的 Meta分析.中国全科医学,2014,12:1388-1393.
2 武旭光.西地那非在慢性阻塞性肺疾病治疗中的应用. 基层医学论坛,2016,20: 3755-3756.
3 中华医学会呼吸病学分会慢性阻塞性肺疾病学组. 慢性阻塞性肺疾病诊治指南(2013年修订版).中华结核和呼吸杂志,2013,36:255-264.
4 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.中华心血管病杂志,2014,42:98.
5 初青莲,吴学杰. 氯毗格雷联合低分子肝素钙治疗慢性肺源性心脏病急性加重期的临床应用.中国综合临床,2014,30:238-240.
6 Martin KB,Klinger JR,Rounds SI.Pulmonary arterial hypertension:newi- nsights and New hope.Respirology,2006,11:6.
7 Crosswhite P,Sun Z.Nitric oxide,oxidative stress and inflammation inpu- lmonaryarterial hypertension.J Hypertens,2010,28:201.
8 苏宏.疏血通注射液辅助治疗 AECOPD 合并慢性肺心病心力衰竭的疗效观察.中西医结合心脑血管病杂志,2017,15: 845-846.
9 盛晓生,林丽,丁明星,等.和肽素水平对大鼠心肾综合征的早期预测价值.中国病理生理杂志,2018,34:264-269.
10 Balling L,Gustafsson F.Copeptin in heart failure.Adv Clin Chem,2016,73: 29-64.
11 高枫,韩肖肖,毕云, 等.慢性心衰患者血清 NT-proBNP 和 cTnI 联合检测及临床意义. 陕西医学杂志, 2017,46:325-327.
12 薛金贵,王肖龙,许勇,等.心脉隆注射液治疗慢性心力衰竭(气阳两虚,瘀血内阻证)的多中心随机对照研究.中国中西医结合杂志,2015,35:796-800.
13 张家美,尚亚东,吴晓蓉,等.心脉隆注射液治疗慢性心力衰竭临床疗效的 Meta分析.中国全科医学,2014,12:1388-1393.