灯盏花素注射液对慢性肺源性心脏病失代偿期血流动力学和心功能影响

Effect of breviscapini injection(灯盏花素注射液) on the hemodynamic and heart function in chronic cor pulmonale patients

目的 :探讨灯盏花素注射液对慢性肺源性心脏病 (肺心病 )患者血流动力学和心功能的影响。方法 :将符合诊断标准的 84例患者随机分为治疗组 4 6例和对照组 38例。对照组选用敏感抗生素 ,常规止咳、祛痰、平喘 ,心功能不全者加用地高辛或利尿剂。治疗组除按对照组上述方法处理外 ,加用灯盏花素注射液 5 0 m g,1次 /d。两组疗程均为 2 0 d。结果 :1治疗组临床控制、显效、好转和无效率分别为 17.39%、4 5 .6 5 %、30 .4 3%和6 .5 2 % ,总有效率为 93.4 8% ;对照组分别为 5 .2 6 %、31.5 8%、39.4 7%、2 3.6 8%和 76 .32 % ;u=14 .2 198,P<0 .0 5 ,治疗组疗效明显优于对照组。 2心功能改善治疗组也好于对照组 (u=14 .2 10 9,P<0 .0 5 )。 3治疗组治疗后血浆黏度及全血高、低切黏度较对照组明显降低 ,动脉血氧分压 (Pa O2 )和动脉血氧饱和度 (Sa O2 )较对照组明显升高 (P均 <0 .0 1)。 4治疗组治疗后平均肺动脉压 (m PAP)、肺血管阻力 (PVR)、心排血量 (CO)和心脏指数 (CI)均较对照组有明显改善 (P均 <0 .0 1)。结论 :灯盏花素能显著改变慢性肺心病患者的血液流变学 ,降低肺动脉高压 ,改善心功能 ,提高失代期临床疗效。

Objective:To investigate the effect of breviscapini injection(灯盏花素注射液) on hemodynamic and heart function in chronic cor pulmonale patient. Methods:Eightyfour cases were randomly divided into two groups: treatment group(46 cases) and control group (38 cases). All patients were treated with antibiotic, relieving cough and asthma, and resolving sputum medicine. Patients with heart failure were treated with digoxin or diuresis. Besides above treatment, the treatment group was treated with breviscapini injection 50 mg once a day intravenously. Two groups were treated for 20 days and clinical efficacy, heart function, hemorrheology, bloodgas analysis were evaluated. Results:①The rate of controlled, notable efficacy, improved, fail and total effectiveness in the treatment group were respectively 17.39 percent, 45.65 percent, 30.43 percent, 6.52 percent, and 93.48 percent, while in the control group they were respectively 5.26 percent, 31.58 percent, 39.47 percent, 23.68 percent and 76.32 percent, the efficacy of the treatment group were superior to those in the control group(u=14.219 8,P<0.05). ②The improvement of heart function in the treatment group was better than those in the control group (u=14.210 9, P<0.05). ③In the treatment group, the blood viscosity, high shear rate viscosity, low shear rate viscosity were decreased, partical pressure of oxygen in artery and arterial oxygen saturation were increased after treatment than those in control group (all P<0.01). ④In treatment group, the levels of mean pulmonary arterial pressure(mPAP), pulmonary vascular resistance(PVR), cardiac output(CO) and cardiac index(CI) were obviously improved compared to those in control group (all P<0.01). Conclusion:Breviscapini injection could remarkablely change the hemorrheology, decrease pulmonary artery hypertension, improve heart function and increase clinical efficacy of chronic cor pulmonale.