左西孟旦联合麝香通心滴丸对LVEF减低心力衰竭患者中的应用及对心肌重塑的影响

Application of levosimendan combined with Shexiang Tongxin Dropping Pills in patients with heart failure with reduced LVEF and its effect on myocardial remodeling

目的探讨左西孟旦联合麝香通心滴丸在射血分数(LVEF)减低心力衰竭(HFrEF)患者中的应用效果及对心肌重塑的影响。方法选择2021年2月-2022年2月HFrEF患者246例为对象,随机数字表法分为对照组与观察组各123例。对照组采用左西孟旦治疗,观察组联合麝香通心滴丸,两组均完成10 d治疗,比较两组心功能、心肌重塑、炎症指标、血清生化指标及药物不良反应。结果两组治疗前、治疗10 d后IVST无统计差异(P>0.05);两组治疗10 d后心功能得到改善,观察组LVEF及6 MWD水平高于对照组(P<0.05);LVEDd、LVESd、LVPWT水平低于对照组(P<0.05);两组治疗10 d后炎性因子得到明显降低,观察组TNFα、IL-6及hs-CRP水平低于对照组(P<0.05);两组治疗10 d后血清生化指标得到降低;观察组治疗后MMP-9及BNP水平低于对照组(P<0.05);两组用药期间血钾偏低、低血压、腹泻便秘、肝肾异常及血钾升高发生率无统计意义(P>0.05)。结论左西孟旦联合麝香通心滴丸能提升HFrEF患者心功能水平,能减轻心肌重塑,降低炎性因子水平,改善血清生化指标,且未增加药物不良反应发生率,值得推广应用。

Objective To investigate the application effect of levosimendan combined with Shexiang Tongxin Dropping Pills in patients with heart failure(HFrEF)with reduced ejection fraction(LVEF)and its effect on myocardial remodeling.Methods A total of 246 patients with HFrEF in February 2021 and February 2022 were selected as the subjects,and they were randomly divided into the control group and the observation group with 123 cases in each group.The control group was treated with levosimendan,and the observation group was combined with Shexiang Tongxin Dropping Pills.Both groups completed 10 d of treatment,and the cardiac function,myocardial remodeling,inflammatory indexes,serum biochemical indexes and adverse drug reactions were compared between the two groups.Results There was no statistical difference in IVST between the two groups before treatment and after 10 days of treatment(P>0.05).After 10 days of treatment,the cardiac function in the two groups was improved,and the levels of LVEF and 6MWD in the observation group were higher than those in the control group(P<0.05).The level of LVEDd、LVESdand LVPWT was lower than that of the control group(P<0.05);inflammatory factors were significantly reduced in the two groups after 10 days of treatment,and the levels of TNFα,IL-6 and hs-CRP in the observation group were lower than those in the control group(P<0.05);the two groups were treated for 10 days The serum biochemical indexes were decreased after treatment;the levels of MMP-9 and BNP in the observation group were lower than those in the control group after treatment(P<0.05);the serum potassium was low,hypotension,diarrhea and constipation,liver and kidney abnormalities and serum potassium increased during the treatment in the two groups,and the incidence was not statistically significant(P>0.05).Conclusion Levosimendan combined with Shexiang Tongxin Dropping Pills can improve cardiac function in patients with HFrEF,reduce myocardial remodeling,reduce inflammatory factor levels,and improve serum biochemical indexes without increasing the incidence of adverse drug reactions,which is worthy of popularization and application.