心脉隆注射液治疗慢性心力衰竭患者的疗效及近期预后的临床研究

发布时间：2018-05-11 07:01

本文选题：慢性心力衰竭 + 心脉隆注射液　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的]通过观察心脉隆注射液配合常规药物治疗慢性心力衰竭患者的疗效和预后相关指标以及与目前常规药物抗心衰治疗对比有无优势,初步探讨心脉隆注射液临床推广应用价值。[方法]将2016年3月到2016年11月在昆明医科大学第二附属医院心内科三病区入院的符合入组条件的慢性心衰患者42例,按随机数表法随机分成常规治疗组及心脉隆治疗组各21例。两组患者均给予规范化常规药物抗心衰治疗,心脉隆治疗组则为常规药物辅以心脉隆注射液治疗,分别在治疗前及治疗5天后、1个月、3个月观察随访各组的左室射血分数、N-端脑利钠肽前体、6分钟步行距离、NYHA心功能分级指标;观察患者住院期间有无药物不良反应;分别于治疗前、随访1个月、随访3个月时对各组患者进行明尼苏达生活质量量表评分;对各组患者均进行3个月的随访,观察患者主要不良心血管事件发生情况,结果进行统计学分析。[结果]1、两组间年龄(t=0.145,P=0.885)、病程(t=0.990,P=0.328)、性别(χ2=0.099,P=0.753)、基础心脏疾病(χ2=0.492,P=0.847)、病情(χ2=0.110,P=0.946)比较无统计学差异(P0.05),两组均衡可比。2、两组左室射血分数(LVEF)比较:两组治疗前LVEF无统计学差异,治疗后、随访1月后、随访3月后较治疗前均升高(P0.05),且心脉隆治疗组LVEF高于常规治疗组(P0.05)。3、两组N-端脑利钠肽前体(NT-proBNP)比较:两组治疗前NT-proBNP无统计学差异,治疗后、随访1月后、随访3月后较治疗前均降低(P0.05),且心脉隆治疗组降低更明显(P0.05)。4、两组6分钟步行距离(6MWD)比较:两组治疗前6MWD无统计学差异,治疗后、随访1月后、随访3月后较治疗前均升高(P0.05),且心脉隆治疗组6MWD高于常规治疗组(P0.05)。5、两组NYHA心功能分级改善情况的比较:心脉隆治疗组NYHA心功能分级显效率(61.90%)高于常规治疗组(19.05%),有统计学差异(χ2=8.005,P=0.005)。6、两组肝肾功能、血小板、血红蛋白指标的观察:两组患者用药后,心脉隆治疗组有1例患者出现血小板减少的情况,余患者未出现明显药物不良反应,两组患者肝功能、血小板、血红蛋白指标治疗前后无统计学差异(P0.05),两组患者肌酐治疗前无统计学差异,治疗后肌酐较治疗前均下降(P0.001),且心脉隆治疗组降低更明显(P0.05)。7、两组明尼苏达生活质量量表(MLHFQ)评分的比较:两组治疗前MLHFQ评分无统计学差异,随访1月后、随访3月后较治疗前均降低(P0.05),且心脉隆治疗组MLHFQ评分低于常规治疗组(P0.05)。8、两组治疗后1个月、3个月主要不良心血管事件(MACE)发生率比较:随访3个月时心脉隆治疗组主要不良心血管事件发生率(14.29%)低于常规治疗组(42.86%),有统计学差异(χ2=4.200;P=0.04)。[结论]1、心脉隆注射液对慢性心力衰竭患者有一定的疗效,且配合现指南推荐的治疗方案有协同作用;2、心脉隆注射液可能改善慢性心力衰竭患者的生活质量及近期预后。
[Abstract]:[objective] to observe the efficacy and prognostic indexes of Xinmailong injection combined with conventional drugs in the treatment of chronic heart failure and whether there are advantages compared with the current anti-heart failure therapy. To explore the clinical application value of Xinmailong injection. [methods] from March 2016 to November 2016, 42 patients with chronic heart failure (CHF) who were admitted to the third ward of Department of Cardiology, second affiliated Hospital of Kunming Medical University, were enrolled in the study. According to the method of random number, the patients were randomly divided into two groups: routine treatment group (21 cases) and cardiolon treatment group (21 cases). The patients in both groups were treated with standardized routine drugs for anti-heart failure, while those in the group treated with Xinmailong injection were treated with routine drugs. Left ventricular ejection fraction (LVEF) and 6-minute walking distance of NCNP precursor were observed before treatment and 5 days, 1 month and 3 months after treatment respectively. The patients in each group were evaluated with Minnesota quality of Life scale before treatment, 1 month after treatment, 3 months after follow-up, and 3 months after follow-up to observe the occurrence of major adverse cardiovascular events in each group. Results Statistical analysis was carried out. [results] 1. There was no significant difference in age between the two groups (蠂 2 / 0. 492P 0. 847, P 0. 010 P 0. 946), and the comparison of left ventricular ejection fraction (LVEF) between the two groups. There was no significant difference in LVEF between the two groups (蠂 2 0. 099 P 0. 946). There was no significant difference between the two groups in left ventricular ejection fraction (LVEF) before treatment. After treatment, there was no significant difference between the two groups in terms of left ventricular ejection fraction (LVEF). After 1 month follow-up, there was no statistical difference between the two groups (蠂 2: 0. 10, P 0. 05, P = 0. 05, P = 0. 05, P = 0. 05, P = 0. 05, P = 0. 05, P < 0. 05). After 3 months of follow-up, the levels of P0.05 and LVEF in the cardiolon treatment group were higher than those in the routine treatment group. The comparison of NT-proBNPs between the two groups: there was no significant difference in NT-proBNP between the two groups before and after treatment, and after one month follow-up, there was no significant difference between the two groups. After 3 months of follow-up, the levels of P0.05D were lower than those before treatment, and the decrease was more obvious in the cardiolon group. The 6-minute walking distance of the two groups was 6MWD. There was no significant difference in 6MWD between the two groups before and after treatment, and after one month follow-up, there was no significant difference between the two groups. After 3 months of follow-up, the levels of P0.05 and 6MWD in the cardiolon treatment group were higher than those in the routine treatment group. The improvement of cardiac function in the two groups was higher than that in the routine treatment group. The difference between the two groups was as follows: the markedly effective rate of NYHA cardiac function grading in the cardiolon treatment group was 61.90) higher than that in the routine treatment group (19.05%). The difference was statistically significant (蠂 ~ 2 / 8.005 P ~ (0.005) P ~ (0.005) 路6). The liver and kidney function of the two groups were as follows: Observation of platelet and hemoglobin index: after two groups of patients were treated, one patient in the treatment group had thrombocytopenia, the remaining patients had no obvious adverse drug reaction, the two groups had liver function, platelet, There was no statistical difference in hemoglobin index before and after treatment (P 0.05), but there was no statistical difference between the two groups before and after treatment with creatinine. After treatment, the creatinine level decreased significantly (P 0.001), and the cardiac myelong group decreased more significantly (P 0.05). The comparison of the Minnesota quality of Life scale (MQL) score between the two groups: there was no significant difference between the two groups before treatment and 1 month after follow-up, and there was no significant difference between the two groups in the score of MLHFQ before treatment, and there was no significant difference between the two groups after one month of follow-up. After 3 months follow-up, all the patients were lower than before treatment, and the MLHFQ score of the cardiolon treatment group was lower than that of the routine treatment group. The incidence of major adverse cardiovascular events in the two groups was 1 month and 3 months after treatment: at the end of 3 months follow-up, the incidence rate of major adverse cardiovascular events was higher in the cardiolabar treatment group than that in the routine treatment group. The incidence of major adverse cardiovascular events (14.29%) was significantly lower than that in the routine treatment group (42.86%) (蠂 ~ 2 = 4.200). [conclusion] 1. Xinmailong injection has a certain curative effect on patients with chronic heart failure, and has synergistic effect in combination with the current guidelines. Xinmailong injection may improve the quality of life and short-term prognosis of patients with chronic heart failure.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.6

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