芪苈强心胶囊对老年慢性心力衰竭患者N末端脑钠肽前体、左心室射血分数、Tei指数的影响
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摘要
目的观察芪苈强心胶囊对老年慢性心力衰竭(chronic heart failure,CHF)患者临床疗效、N末端脑钠肽前体(N-terminal pro-brain natriuretic peptide,NT-proBNP)、左心室射血分数(left ventricular ejection fraction,LVEF)、Tei指数的影响。方法选择2014年6月至2015年7月在云南省第二人民医院门诊及住院部医治的170例老年CHF患者,采用数字表法随机分为2组,对照组85例,给予标准心力衰竭治疗;治疗组85例,在对照组治疗基础上加服芪苈强心胶囊(4粒,每日3次)。疗程均为3个月。观察并比较2组患者治疗前后临床疗效以及NT-proBNP水平、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、LVEF、Tei指数的变化。结果治疗3个月后,治疗组临床疗效明显优于对照组(88. 1%比63. 4%,P <0. 05)。2组患者治疗后NT-proBNP水平下降,治疗组优于对照组(P <0. 05)。2组患者LVEDD、Tei指数均降低(P <0. 05),LVEF增加(P <0. 05),治疗组上述指标改善均优于对照组(P <0. 05)。2组均未发现明显不良反应。结论芪苈强心胶囊能在标准心力衰竭基础上进一步降低NT-proBNP、LVEDD、Tei指数,提高LVEF,改善老年CHF患者心功能,且安全性好。
Objective To investigate the effect of Qiliqiangxin capsule on clinical efficacy,Nterminal pro-brain natriuretic peptide( NT-proBNP),left ventricular ejection fraction( LVEF) and Tei index in elder patients with chronic heart failure( CHF). Methods A total of 170 elder patients with CHF were collected from June 2014 to July 2015 in the clinic of Yunnan Second People's Hospital. All the patients were randomly divided into two groups by random number table method. In the control group,85 patients were treated with standard treatment for heart failure. In the treatment group,85 patients were given Qiliqangxin capusule additionally( 4 granules,3 times daily). The course of treatment was 3 months. The clinical efficacy,NT-proBNP,left ventricular end-diastolic diameter( LVEDD),LVEF and Tei index of both groups were observed and compared before and after treatment. Results After 3 months of treatment,clinical efficacy of the treatment group was significantly higher than that in the control group( 88. 1% vs. 63. 4%,P < 0. 05). In both groups,NT-proBNP levels,LVEDD and Tei index were significantly reduced after treatment( P < 0. 05),and LVEF was significantly increased( P < 0. 05). In addition,the improvements of the above indicators in the treatment group were better than those in the control group( P < 0. 05). Side effects were neither found in the two groups. Conclusion Qiliqiangxin capsule can further reduce the level of NT-proBNP,LVEDD and Tei index,increase LVEF,and improve the cardiac function in elder CHF patients who received standard heart failure treatment with good safety.
Objective To investigate the effect of Qiliqiangxin capsule on clinical efficacy,Nterminal pro-brain natriuretic peptide( NT-proBNP),left ventricular ejection fraction( LVEF) and Tei index in elder patients with chronic heart failure( CHF). Methods A total of 170 elder patients with CHF were collected from June 2014 to July 2015 in the clinic of Yunnan Second People's Hospital. All the patients were randomly divided into two groups by random number table method. In the control group,85 patients were treated with standard treatment for heart failure. In the treatment group,85 patients were given Qiliqangxin capusule additionally( 4 granules,3 times daily). The course of treatment was 3 months. The clinical efficacy,NT-proBNP,left ventricular end-diastolic diameter( LVEDD),LVEF and Tei index of both groups were observed and compared before and after treatment. Results After 3 months of treatment,clinical efficacy of the treatment group was significantly higher than that in the control group( 88. 1% vs. 63. 4%,P < 0. 05). In both groups,NT-proBNP levels,LVEDD and Tei index were significantly reduced after treatment( P < 0. 05),and LVEF was significantly increased( P < 0. 05). In addition,the improvements of the above indicators in the treatment group were better than those in the control group( P < 0. 05). Side effects were neither found in the two groups. Conclusion Qiliqiangxin capsule can further reduce the level of NT-proBNP,LVEDD and Tei index,increase LVEF,and improve the cardiac function in elder CHF patients who received standard heart failure treatment with good safety.
引文
1顾东风,黄广勇,何江,等.中国心力衰竭流行病学调查及其患病率[J].中华心血管病杂志,2003,31(1):3-6
2中国心血管病报告编写组.《中国心血管病报告2016》概要[J].中国循环杂志,2017,32(6):521-530.
3周京敏,崔晓通,葛均波.中国心力衰竭的流行病学概况[J].中华心血管病杂志,2015,43(12):1018-1021.
4张健,张宇辉.多中心、前瞻性中国心力衰竭注册登记研究---病因、临床特点和治疗情况初步分析[J].中国循环杂志,2015,30(5):413-416.
5李琳,莫卿,莫婷,等.老年CHF患者临床特征和药物治疗状况多中心回顾性分析[J].中华医学杂志,2018,98(9):673-677.
6刘蕊,卜丽梅.老年CHF的治疗进展[J].中国老年学杂志,2013,33(23):6059-6061.
7魏聪,贾振华,吴以岭,等.芪苈强心胶囊对兔实验性CHF心室重构的保护作用[J].疑难病杂志,2007,6(3):144-147.
8 Zou Y,Lin L,Ye Y,et al.Qiliqiangxin inhibits the development of cardiac hypertrophy,remodeling,and dysfunction during 4 weeks of pressure overload in mice[J].J Cardio Pharmacol,2012,59(3):268-280.
9徐涛,郭丽峰,陈立锋,等.芪苈强心胶囊对慢性心力衰竭大鼠心肌细胞凋亡的影响[J].中药新药与临床药理,2010,21(4):366-369.
10 Zhang J,Wei C,Wang H,et al.Protective effect of qiliqiangxin capsule on energy metabolism and myocardial mitochondria in pressure overload heart failure rats[J].Evid Based Complement Alternat Med,2013,2013:378298.
11马柳一,尹玉洁,张军芳,等.芪苈强心胶囊对慢性心衰大鼠下丘脑室旁核RAS系统及交感神经系统的影响[J].中国药理学通报,2016,32(4):575-580.
12韩安邦,张健,路迎冬,等.芪苈强心胶囊对心肌梗死大鼠心肌纤维化及TGF-β1/Smad3信号通路的影响[J].北京中医药大学学报,2017,40(1):41-47.
13 Bettencourt P.NT-proBNP and BNP:biomarkers for heart failure management[J].Eur J Heart Fail,2014,6(3):359-363.
14黄创,李霖,郭鹏,等.N末端B型钠尿肽前体与老年心功能不全相关性的临床研究[J/CD].中国医学前沿杂志(电子版),2014,6(8):85-88.
15 Huynh K.Heart failure:Improvement of LVEF in patients with HF is linked to better prognosis[J].Nature Rev Cardiol,2016,13(9):505.
16 Larina VN,Biu B,Dergunova EN,et al.Prognostic value of the myocardial performance(Tei)index in patients with chronic heart failure[J].Kardiologiia,2013,53(11):37.
17 Ogunmola OJ,Akintomide AO,Olamoyegun AM.Relationship between clinically assessed heart failure severity and the Tei index in Nigerian patients[J].Bmc Res Notes,2013,6(1):1-6.
18刘树峰,严晓红,肖敦宏,等.芪苈强心胶囊辅治慢性心力衰竭患者的疗效及其对NT-proBNP、LVEF及Tei指数的影响[J].疑难病杂志,2017,16(5):505-508.
19唐淑云,王登旭,燕芳芳,等.芪苈强心胶囊对慢性心力衰竭患者的治疗作用[J].中国老年学杂志,2013,33(17):4106-4108.
2中国心血管病报告编写组.《中国心血管病报告2016》概要[J].中国循环杂志,2017,32(6):521-530.
3周京敏,崔晓通,葛均波.中国心力衰竭的流行病学概况[J].中华心血管病杂志,2015,43(12):1018-1021.
4张健,张宇辉.多中心、前瞻性中国心力衰竭注册登记研究---病因、临床特点和治疗情况初步分析[J].中国循环杂志,2015,30(5):413-416.
5李琳,莫卿,莫婷,等.老年CHF患者临床特征和药物治疗状况多中心回顾性分析[J].中华医学杂志,2018,98(9):673-677.
6刘蕊,卜丽梅.老年CHF的治疗进展[J].中国老年学杂志,2013,33(23):6059-6061.
7魏聪,贾振华,吴以岭,等.芪苈强心胶囊对兔实验性CHF心室重构的保护作用[J].疑难病杂志,2007,6(3):144-147.
8 Zou Y,Lin L,Ye Y,et al.Qiliqiangxin inhibits the development of cardiac hypertrophy,remodeling,and dysfunction during 4 weeks of pressure overload in mice[J].J Cardio Pharmacol,2012,59(3):268-280.
9徐涛,郭丽峰,陈立锋,等.芪苈强心胶囊对慢性心力衰竭大鼠心肌细胞凋亡的影响[J].中药新药与临床药理,2010,21(4):366-369.
10 Zhang J,Wei C,Wang H,et al.Protective effect of qiliqiangxin capsule on energy metabolism and myocardial mitochondria in pressure overload heart failure rats[J].Evid Based Complement Alternat Med,2013,2013:378298.
11马柳一,尹玉洁,张军芳,等.芪苈强心胶囊对慢性心衰大鼠下丘脑室旁核RAS系统及交感神经系统的影响[J].中国药理学通报,2016,32(4):575-580.
12韩安邦,张健,路迎冬,等.芪苈强心胶囊对心肌梗死大鼠心肌纤维化及TGF-β1/Smad3信号通路的影响[J].北京中医药大学学报,2017,40(1):41-47.
13 Bettencourt P.NT-proBNP and BNP:biomarkers for heart failure management[J].Eur J Heart Fail,2014,6(3):359-363.
14黄创,李霖,郭鹏,等.N末端B型钠尿肽前体与老年心功能不全相关性的临床研究[J/CD].中国医学前沿杂志(电子版),2014,6(8):85-88.
15 Huynh K.Heart failure:Improvement of LVEF in patients with HF is linked to better prognosis[J].Nature Rev Cardiol,2016,13(9):505.
16 Larina VN,Biu B,Dergunova EN,et al.Prognostic value of the myocardial performance(Tei)index in patients with chronic heart failure[J].Kardiologiia,2013,53(11):37.
17 Ogunmola OJ,Akintomide AO,Olamoyegun AM.Relationship between clinically assessed heart failure severity and the Tei index in Nigerian patients[J].Bmc Res Notes,2013,6(1):1-6.
18刘树峰,严晓红,肖敦宏,等.芪苈强心胶囊辅治慢性心力衰竭患者的疗效及其对NT-proBNP、LVEF及Tei指数的影响[J].疑难病杂志,2017,16(5):505-508.
19唐淑云,王登旭,燕芳芳,等.芪苈强心胶囊对慢性心力衰竭患者的治疗作用[J].中国老年学杂志,2013,33(17):4106-4108.