参松养心胶囊联合沙库巴曲缬沙坦治疗阵发性心房颤动合并慢性心力衰竭对hs-CRP、BNP、AngⅡ及心功能的影响

Effects of Shensong Y angxin Capsule(参松养心胶囊)Combined with Sacubatro Valsartan on hs-CRP,BNP,Ang II and Cardiac Function in Treatment of Paroxysmal Atrial Fibrillation Complicated with Chronic Heart Failure

目的 探讨参松养心胶囊联合沙库巴曲缬沙坦治疗阵发性心房颤动合并慢性心力衰竭对高敏C反应蛋白(High sensitivity C-reactive protein, hs-CRP)、脑钠肽(Brain natriuretic peptide, BNP)、血管紧张素Ⅱ(AngiotensinⅡ,AngⅡ)及心功能的影响。方法 选取100例阵发性心房颤动合并慢性心力衰竭患者,随机分为对照组与观察组,每组50例,对照组在常规治疗基础上给予沙库巴曲缬沙坦口服,观察组在常规治疗基础上给予参松养心胶囊联合沙库巴曲缬沙坦口服治疗,疗程6个月。观察血清hs-CRP、BNP、AngⅡ、左心室射血分数(Left ventricular ejection fraction, LVEF)、左室收缩末期内径(Left ventricular end systolic diameter, LVESD)、左室舒张末期内径(Left ventricular end diastolic diameter, LVEDD)变化。结果 两组治疗前血清hs-CRP、BNP、AngⅡ比较差异无统计学意义(P>0.05),治疗后下降(P<0.05),且观察组低于对照组(P<0.05);两组治疗前LVEF、LVESD、LVEDD比较差异无统计学意义(P>0.05),治疗后LVEF升高(P<0.05),且观察组高于对照组(P<0.05),治疗后LVESD、LVEDD下降(P<0.05),且观察组低于对照组(P<0.05);两组治疗前阵发性心房颤动发作次数、阵发性心房颤动持续时间、心室率比较差异无统计学意义(P>0.05),治疗后下降(P<0.05),且观察组低于对照组(P<0.05);对照组转为持续性心房颤动、心力衰竭恶化、缺血心源性死亡率分别为20.00%、22.00%、4.00%,观察组分别为4.00%、6.00%、0.00%,转为持续性心房颤动、心力衰竭恶化发生率对照组高于观察组(P<0.05);观察组治疗疗效优于对照组(P<0.05)。结论 参松养心胶囊联合沙库巴曲缬沙坦治疗阵发性心房颤动合并慢性心力衰竭有助于促进hs-CRP、BNP、AngⅡ下降,改善患者心功能,改善预后。

Objective To investigate the effects of Shensong Yangxin Capsule(参松养心胶囊)combined with sacubatro val-sartan on high-sensitivity C-reactive protein(hs-CRP),brain natriuretic peptide(BNP),angiotensinⅡ(AngⅡ)and cardi-ac function in the treatment of paroxysmal atrial fibrillation complicated with chronic heart failure.Methods A hundred cases with paroxysmal atrial fibrillation complicated with chronic heart failure were selected and randomly divided into control group and ob-servation group,50 cases in each group.The control group was given sacubatro valsartan orally on the basis of the conventional treatment.The observation group was given Shensong Yangxin Capsule combined with sacubatro valsartan orally on the basis of the conventional treatment.The treatment course lasted for 6 months.The changes of serum hs-CRP,BNP,AngⅡ,left ventricu-lar ejection fraction(LVEF),left ventricular end systolic diameter(LVESD)and left ventricular end diastolic diameter(LVEDD)were observed.Results There were no significant differences in serum hs-CRP,BNP or AngⅡbetween the two groups before treatment(P>0.05)and the indexes decreased after treatment(P<0.05).The levels of serum hs-CRP,BNP and AngⅡin the observation group were lower than those of the control group(P<0.05).There were no significant differences in LVEF,LVESD or LVEDD between the two groups before treatment(P>0.05).LVEF increased after treatment(P<0.05),and that in the observation group was higher than that in the control group(P<0.05),LVESD and LVEDD decreased after treatment(P<0.05),and those in the observation group were lower than those of he control group(P<0.05).There was no significant differ-ence in the number of paroxysmal atrial fibrillation,duration of paroxysmal atrial fibrillation or ventricular rate between the two groups before treatment(P>0.05).These indexes decreased after treatment(P<0.05),and the indexes in the observation group were lower than those of the control group(P<0.05).The mortality rates of persistent atrial fibrillation,worsening heart failure and absence of heart source were 20.00%,22.00%and 4.00%in the control group,and 4.00%,6.00%and 0.00%in the observation group,respectively.The incidence of persistent atrial fibrillation and worsening heart failure in the control group was higher than that in the observation group(P<0.05).The therapeutic effect of the observation group was better than that of the control group(P<0.05).Conclusion Shensong Yangxin Capsule combined with sacubatro valsartan can promote the decrease of hs-CRP,BNP and AngⅡin the treatment of paroxysmal atrial fibrillation complicated with chronic heart failure and improve the cardiac function and prognosis of patients.