心脉龙治疗肺心病心衰的机制探讨

Mechanism Exploration of Xinmailong Treatment ofCor Pulmonale Patients with Heart Failure

应用心脉龙注射液治疗肺心病心衰患者，探讨其作用机制．对６０例肺心病Ⅱ度心衰患者，随机分为对照组（地戈辛＋酚妥拉明，Ａ组），心脉龙治疗组（Ｂ组），用ＳＰＥＣＴ心血池动态显像术，观察其对右心室收缩、舒张功能、ＲＶＦＦ，１／３ＥＦ，ＲＶＰＦＲ，１／３ＦＦ及血浆ＥＴ，ＡＮＰ的影响．对比观察各组用药前后及两组间治疗后，右心室血液动力学效应，心脏内分泌变化．结果Ｂ组治疗后右心室收缩、舒张功能均有显著改善（Ｐ＜００５或Ｐ＜００１）的同时ＥＴ，ＡＮＰ亦随之显著降低（Ｐ＜００５或Ｐ＜００１）；Ｂ组与Ａ组比，治疗后心功能改善显著优于Ａ组（Ｐ＜００５或Ｐ＜００１）．结果表明心脉龙具有正性肌力作用，其扩张肺血管，降低肺动脉高压，改善右心室舒张功能的机制是拮抗ＥＴ．

Aiming at its mechanism exploration, Xinmailong injection was applied in treating cor pulmonale patients with II-phase heart failure. 60 cases of cor pulmonale patients with II-phase heart failure were randomly divided into two: control (Digoxi+Regiline, A) group and treatment (Xinmailong, B) group. SPECT blood-pool radionuclide ventriculography was used to observe the drug action on RVEF, 1/3 EF, RVPFR, 1/3 FF, plasma ET and ANP. The hemodynamic effect of right ventricle and the endocrine change of heart were observed comparatively between the groups both before and after the drug administration. In result, the contractive and relaxant functions of right ventricle were obviously improved (P<0.05 or P<0.01) and meanwhile ET and ANP apparently declined (P<0.05 or P<0.01) in group B after the treatment; and the cardiac function level was improved more significantly after the treatment in group B than in group A (P<0.05 or P<0.01). The results disclosed that Xinmailong has a function of contracting ventricular muscle and that its mechanism of expanding pulmonary artery and bettering relaxant function of right ventricle is in relation to its anti-function to ET.