参附注射液治疗急性失代偿性心力衰竭的随机对照临床研究

发布时间：2018-04-18 04:05

本文选题：心力衰竭 + 肌钙蛋白T　；参考：《中华老年心脑血管病杂志》2017年01期

【摘要】：目的观察参附注射液治疗急性失代偿性心力衰竭(ADHF)的临床疗效,探讨可能的作用机制。方法入选ADHF患者100例,采用随机数字表法分为参附组和对照组,每组50例,2组均给予常规治疗心力衰竭药物,参附组给予参附注射液80ml+5%葡萄糖100ml静脉滴注,疗程10~14d。检测治疗前后血浆N末端B型脑钠肽前体(NT-proBNP)、肌钙蛋白T(cTnT)、白细胞介素(IL)-6、IL-8、IL-10、TNF-α及LVEF、左心室舒张末容积(LVEDV)、左心室短轴缩短率(LVFS)等相关指标,评估2组患者治疗后心功能(NYHA)分级的改善情况,6min步行距离(6-MWD),同时观察药物的不良反应。结果参附组治疗后总有效率明显高于对照组(96.0%vs80.0%,χ2=7.212,P=0.027),6-MWD较对照组明显延长[(473.06±24.09)mvs(430.09±23.31)m,P=0.043)];2组治疗后NT-proBNP、cTnT、IL-6、IL-8、TNF-α和LVEDV较治疗前下降,IL-10、LVFS、LVEF较治疗前升高,参附组变化幅度明显高于对照组,差异有统计学意义(P0.05);参附组3例出现皮疹、1例出现头痛等不良反应。结论参附注射液改善ADHF患者心功能的机制可能为降低促炎性因子,升高抗炎性因子表达,纠正心力衰竭时两者的失衡状态。
[Abstract]:Objective to observe the clinical effect of Shenfu injection in the treatment of acute decompensated heart failure and explore the possible mechanism.Methods 100 patients with ADHF were randomly divided into Shenfu group (n = 50) and control group (n = 50). Each group (n = 50) was given routine treatment of heart failure and Shenfu injection (80ml 5% glucose 100ml) was given intravenously for 10 days.Plasma N-terminal B-type brain natriuretic peptide precursor (NT-proBNPN), troponin TcTnTnTnTnTX, IL-8 IL-8, IL-10 TNF- 伪 and LVEF, left ventricular end-diastolic volume (LVEDVV), left ventricular shortening rate (LVFSs) and so on were measured before and after treatment.Objective: to evaluate the improvement of NYHA classification after treatment in two groups, and to observe the adverse drug reactions.Results the total effective rate after treatment in Shenfu group was significantly higher than that in control group (96.0vs80.0.蠂 ~ 27.212P ~ 0.02727D was significantly longer than that in control group [473.06 卤24.09)mvs(430.09 卤23.31mPnTnTnTnTnTnTnTnTnTnTnTnTnTnTnTnTnTnTnTnTnTnTnTnTnTnTnTnTNF- 伪 and LVEDV decreased before treatment. The LVFSLVEF of Shenfu group was significantly higher than that of control group, and the change of LVFS-LVEF in Shenfu group was significantly higher than that in control group.The difference was statistically significant (P 0.05), and in the Shenfu group, 3 cases had skin rash and 1 case had headache and other adverse reactions.Conclusion the mechanism of Shenfu injection in improving cardiac function in patients with ADHF may be to decrease the pro-inflammatory factors, increase the expression of anti-inflammatory factors, and correct the imbalance of the two factors in heart failure.
【作者单位】：郑州大学第一附属医院心内科;
【分类号】：R541.6

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