血脂康抗心衰药效的临床研究及其降低血浆脑钠肽的相关性

Cardiac protection effect of Xuezhikang on patients with chronic heart failure correlates positively to lowering plasma brain natriuretic peptide levels

目的:观察血脂康对慢性心力衰竭患者心功能、血浆脑钠肽和高敏C反应蛋白水平的影响,评价该药抗心衰疗效,初步探讨其作用机制。方法:80例慢性心力衰竭患者随机分为观察组和对照组,常规抗心衰治疗,观察组加服血脂康,疗程8周。治疗前后用彩超测定左心室射血分数(LVEF)和左心室舒张末期内径(LVDd),以ELISA法与散射比浊法分别测定血浆N-末端脑钠肽前体(NT-proBNP)和高敏C反应蛋白(HS-CRP)水平。结果:治疗后观察组总有效率明显高于对照组,LVEF明显升高、LVDd明显下降,血浆NT-proBNP、HS-CRP水平均明显下降;观察组血浆NT-proBNP与LVEF呈负相关(r=-0.72,P<0.05),与LVDd呈正相关(r=0.75,P<0.05);血浆HS-CRP水平与LVDd呈正相关(r=0.31,P<0.05),与LVEF增加呈负相关(r=-0.387,P<0.05)。结论:血脂康能降低血浆NT-proBNP、HS-CRP水平,抑制左心室重构,改善心脏功能,在慢性心力衰竭防治中起重要作用;其作用机制可能与改善神经体液功能有关。

AIM：To observe the cardiac protection effect of Xuezhikang on cardiac function in patients with chronic heart failure（CHF） and its relation with plasma N-terminal pro-brain natriuretic peptide（NT-proBNP） and high-sensitivity high-sensitivity C-reactive protein（HS-CRP） levels. METHODS：80 patients with CHF were randomly divided into two groups;the control group received routine anti-failure treatment,and the observation group received routine anti-failure treatment in combination with Xuezhikang for 8 weeks.The cardiac function,i.e.,left ventricular ejection fraction（LVEF）,left ventricular end-diastolic diameter（LVDd）,were measured before and after treatment with color Doppler ultrasound;plasma NT-proBNP,HS-CRP levels were determined by ELISA method and nephelometry respectively.RESULTS：The cardiac function improved more effectively in the observation group than that in the control group.The LVEF increasing and LVDd decreasing were correlated to plasma NT-proBNP levels（r=-0.72 and 0.75,P0.05 respectively） and HS-CRP levels（r=-0.387 and 0.31,P0.05）.CONCLUSION：Xuezhikang is effective in anti-failure treatment.Reducing plasma NT-proBNP and HS-CRP levels may be the possible mechanism of the drug,but NT-proBNP reducing is more important.