目的 探讨生脉注射液联合托拉塞米片治疗慢性心力衰竭的临床疗效。方法 选择2020年6月-2022年8月在空军第九八六医院就诊的88例慢性心力衰竭患者,依据随机数字表法将全部患者分为对照组和治疗组,每组各44例。对照组口服托拉塞米片,1片/次,1次/d。治疗组在对照组基础上静脉滴注生脉注射液,每次剂量40mL加入5%葡萄糖注射液250mL中,1次/d。两组患者连续治疗14 d。观察两组患者临床疗效,比较治疗前后两组患者6 min步行实验(6 MWT)、心功能、心率变异性、B型利钠肽原(proBNP)、血小板平均体积(MPV)、红细胞分布宽度(RDW)。结果 治疗后,治疗组的总有效率为95.45%,明显高于对照组的总有效率81.82%,组间差异有统计学意义(P<0.05)。治疗后,两组的6 MWT均明显增大(P<0.05),治疗组的6 MWT较对照组增大更明显(P<0.05)。治疗后,两组左室射血分数(LVEF)明显增大,左室收缩末期内径(LVDS)明显减小(P<0.05);治疗后治疗组的LVEF高于对照组,LVDS低于对照组,差异有统计学意义(P<0.05)。治疗后,两组的窦性间期平均值(SDANN)、窦性间期标准差(SDNN)、相邻窦性间期差的变异系数(RMSSD)均明显升高(P<0.05),且治疗组的SDANN、SDNN、RMSSD高于对照组,差异有统计学意义(P<0.05)。治疗后,两组的血清proBNP、MPV、RDW均明显低于治疗前(P<0.05),且治疗组的血清proBNP、MPV、RDW明显低于对照组,差异有统计学意义(P<0.05)。结论 生脉注射液联合托拉塞米片治疗慢性心力衰竭的疗效确切,能改善心功能和心率变异性,降低血清proBNP、MPV、RDW。

Objective To investigate the clinical efficacy of Shengmai Injection combined with Torsemide Tablets in treatment of chronic heart failure. Methods Patients (88 cases) with chronic heart failure in 986 Air Force Hospital from June 2020 to August 2022 were divided into control and treatment groups according to random number table method, and each group had 44 cases. Patients in the control group were po administered with Torsemide Tablets, 1 tablet/time, once daily. Patients in the treatment group were iv administered with Shengmai Injection on the basis of the control group, 40 mL added into 5% glucose solution 250 mL, once daily. Patients in two groups were treated for 14 d. After treatment, the clinical efficacies were evaluated, and the 6 MWT, cardiac function, heart rate variability, proBNP, and MPV, RDW in two groups were compared. Results After treatment, the total effective rate of the treatment group was 95.45%, which was significantly higher than that of the control group (81.82%), with a statistically significant difference (P＜0.05). After treatment, the 6 MWT in two groups were significantly increased (P＜0.05), and the 6 MWT in the treatment group was significantly longer than that in the control group (P＜0.05). After treatment, LVEF in two groups were significantly increased, but LVDS in two groups significantly decreased (P＜0.05); After treatment, LVEF in the treatment group was higher than that in the control group, but LVDS in the treatment group was lower than that in the control group, with a statistically significant difference (P＜0.05). After treatment, SDANN, SDNN, and RMSSD in two groups were significantly increased (P＜0.05), and the SDANN, SDNN, and RMSSD in the treatment group were higher than those in the control group, with a statistically significant difference (P＜0.05). After treatment, the proBNP, MPV, and RDW of two groups were significantly lower than those before treatment (P＜0.05), and the proBNP, MPV, and RDW of the treatment group were significantly lower than those of the control group (P＜0.05). Conclusion Shengmai injection combined with Torsemide Tablets is effective in treatment of chronic heart failure, which can improve clinical efficacy, improve cardiac function and heart rate variability, and reduce the levels of proBNP, MPV and RDW.

R972

陕西省自然科学基础研究计划项目(2021JM-230)