川芎嗪联合坎地沙坦酯治疗慢性肺心病急性加重期疗效观察

Therapeutic Effect of Ligustrazine Plus Candesartan in Treatment of Chronic Cor Pulmonale in Acute Exacerbation

目的探讨川芎嗪注射液与坎地沙坦酯联合治疗慢性肺心病急性加重期的疗效。方法选择我院74例慢性肺心病急性加重期患者,随机分为治疗组38例和对照组36例,两组患者根据药敏试验选择有效抗生素、强心利尿、镇咳祛痰、持续低流量吸氧、维持水电解质平衡等常规治疗,治疗组在上述治疗的基础上,加用川芎嗪与坎地沙坦酯治疗2周,比较两组疗效及治疗前后血气分析、血液流变学相关指标有无差异。结果两组患者治疗后疗效间差异有统计学意义(P<0.05);治疗后两组患者血浆黏度、全血黏度比较差异均有统计学意义(P<0.05);应用川芎嗪与坎地沙坦酯治疗后血pH、动脉血氧分压、二氧化碳分压、血氧饱和度比较,差异均有统计学意义(P<0.05)。结论在常规治疗基础上川芎嗪与坎地沙坦酯联合治疗可以更好地改善老年肺心病心力衰竭患者的心功能和临床症状,亦能明显改善肺血管及右心室重构,降低肺动脉压。

Objective To explore the effects of ligustrazine combined with eandesartan in the treatment of chronic cot pulmonale in acute exacerbation. Methods Totally 74 patients with chronic eor pulmonale in acute exacerbation were randomly divided into groups trial （ n = 38） and control （n = 36）. Both were treated, based on susceptibllty tests, with conventional therapy such as effective antibiotics, cardiac diuretics, antitussive expectorant, continuous low - flow oxygen inhalation and balance of water and electrolyte maintenance. Trial group were additionally given ligustrazine combined with candesartan, 2 weeks. The effects and pre - and post - treatmetn blood gas analyses, hemorheologieal indexes were compared between 2 groups. Results There was significant difference between 2 groups in effect after treatment （P 〈 0. 05） , and in plasma viscosity, whole blood viscosity （P 〈0. 05） , and in effect, pH, arterial partial pressure of oxygen, carbon dioxide partial pressure, oxygen saturation levels after ligustrazine and candesartan treatment （ P 〈 0.05 ）. Conclusion Ligustrazine and candesartan based on conventional treatment in cor pulmonale in acute exacerbation can improve the cardiac function and clinical symptoms, remodeling of pulmonary vascular and right ventricular, and reduce pulmonary artery pressure in elderly patients with cor pulmonale complicated by heart failure.