[关键词]
[摘要]
目的 探讨参附注射液联合磷酸肌酸钠对扩张型心肌病心力衰竭患者心功能、心率变异性和血清脑利钠肽(BNP)的影响。方法 选择2016年8月-2019年2月在陕西省核工业二一五医院心内科收治的扩张型心肌病心力衰竭患者122例,根据随机数字表法把患者分为对照组与观察组,每组各61例。对照组静脉滴注注射用磷酸肌酸钠,1 g注射用磷酸肌酸钠用0.9%氯化钠注射液溶解后进行静脉滴注30 min左右,1次/d。观察组在对照组治疗的基础上给予参附注射液治疗,20 mL加入0.9%葡萄糖250 mL进行30 min左右静脉滴注,1次/d。两组均治疗14 d。记录两组患者的心功能指标、心率变异性及BNP的变化情况,比较两组的心脏不良事件的发生情况。结果 治疗后,两组左心房内径(LA)值显著低于治疗前(P<0.05),左室射血分数(LVEF)值显著高于治疗前(P<0.05),且观察组心功能指标均优于对照组(P<0.05)。两组治疗后的PNN50与RMSSD值都显著高于治疗前(P<0.05),且观察组PNN50与RMSSD值均明显高于对照组(P<0.05)。两组治疗后的血清BNP值均低于治疗前(P<0.05),且观察组BNP值明显低于对照组(P<0.05)。观察组治疗后6个月主要心脏不良事件发生率为4.9%,显著低于对照组的19.7%(P<0.05)。结论 参附注射液联合磷酸肌酸钠治疗扩张型心肌病心力衰竭能改善患者的心功能及心率变异性,抑制BNP的释放,减少主要心脏不良事件的发生,具有临床推广应用价值。
[Key word]
[Abstract]
Objective To investigate the effects of Shenfu Injection combined with creatine phosphate sodium on cardiac function, heart rate variability, and serum BNP in patients with dilated cardiomyopathy with heart failure. Methods Patients (122 cases) with dilated cardiomyopathy and heart failure in the NO.215 Hospital of Shaanxi Nuclear Industry from August 2016 to February 2019 were enrolled, and divided into control group and observation group, each group had 61 cases. Patients in the control group were iv administered with Creatine Phosphate Sodium for Injection, 1 g was dissolved in 0.9% sodium chloride injection, followed by intravenous infusion for 30 min, once daily. Patients in the observation group was treated with Shenfu Injection on the basis of the control group, and 20 mL was added with 0.9% glucose 250 mL for intravenous infusion for 30 min, once daily. Patients in two groups were treated for 14 d. The changes of cardiac function indexes, heart rate variability, and BNP in two groups were recorded, and the occurrence of adverse cardiac events in two groups was compared. Results After treatment, the LA value in two groups after treatment was significantly lower than that before treatment, and the LVEF value was significantly increased (P<0.05), and the cardiac function indexes in the observation group were better than those in the control group (P<0.05). After treatment, PNN50 and RMSSD values in two groups were significantly higher than those before treatment (P<0.05), and PNN50 and RMSSD values in the observation group were significantly higher than those in the control group (P<0.05). After treatment, serum BNP values in two groups were lower than that before treatment (P<0.05), and BNP values in the observation group were significantly lower than those in the control group (P<0.05). The incidence of major adverse cardiac events in the observation group at 6 months after treatment was 4.9%, which was significantly lower than 19.7% in the control group (P<0.05). Conclusion Shenfu Injection combined with creatine phosphate sodium in treatment of heart failure in dilated cardiomyopathy can improve the cardiac function and heart rate variability, inhibit the release of BNP, and reduce the occurrence of major adverse cardiac events, it has clinical application value.
[中图分类号]
R972
[基金项目]
陕西省科技攻关项目2016YFJH2-07