磷酸肌酸钠对老年舒张性心力衰竭者血清超敏C反应蛋白、同型半胱氨酸、尿酸的影响

Effects of creatine phosphate sodium on serum hs-CRP, HCY, UA in elderly coronary heart failure with diastolic heart failure patients

目的通过观察磷酸肌酸钠（SCP）对老年冠心病舒张性心力衰竭（diastolic heart failure，DHF）者血清超敏C反应蛋白（hs—CRP）、同型半胱氨酸（HCY）、尿酸（UA）水平影响，探讨SCP改善老年冠心病DHF的可能机制。方法选择哈尔滨医科大学附属第四医院2012年11月-2013年4月心脏超声明确DHF诊断住院患者86例，其中男56例、女30例，平均年龄（82．1±3．4）岁。86例患者分为A组（对照组n=20）、B组（药物组／7=66），A组予常规治疗，B组常规治疗基础上予SCP注射液2．0g＋5％葡萄糖注射液100mL静脉滴注，1次／日，连续2W。患者分圳丁用药前、用药后1、2W时榆测血清hs—CRP、HCY及UA含量，2W后行心脏功能检测。结果（1）两组患者治疗有效率A组75．0％、B组89．4％；（2）治疗1、2W时各组患者血清hs—CRP、HCY、UA水平较治疗前下降，2W时血hs—CRP、HCY、UA水平与治疗前相比差异有统计学意义（hs—CRP：P=0．032，HCY：P=0．021，UA：P〈0．001），治疗后B组HCY、UA水平下降较A组明显，差异有统计学意义（HCY：P=0．031，UA：P=0．023）；（3）各组患者2W后较治疗前左室射血分数（LVEF）、左心室短轴缩短率（FS）升高，舒张早期二尖瓣血流峰值（E峰）升高、舒张晚期二尖瓣血流峰值（A峰）下降、E／A比值增加，差异有统计学意义（LVEF：P〈0．001，FS：P=0．013，E峰：P=0．024，A峰：P=0．047，E／A：P〈0.001）；B组变化较A组明显，差异有统计学意义（LVEF：P〈0．001，FS：P=0，037，E峰：P=0．045，A峰：P〈0．001，E／A：P=0．028）。结论（1）磷酸肌酸钠可改善老年冠心病舒张性心力衰竭者心功能；（2）磷酸肌酸钠可影响老年冠心病舒张性心力衰竭者血清HCY、UA水平，对hs—CRP的影响不明显，

Objective To observe the changing of serum hs-CRP/HCY/UA by the treatment with Creatine Phosphate Sodium in old patients with coronary heart disease （CHD） and diastolic heart failure （DHF） and to explore the possible mechanisms of SCP improving the prognosis of DHF. Methods Eighty-six elderly coronary heart disease （CHD） patients which were diagnosed as diastolic heart failure by echocardiogram were enrolled during November 2012 to April 2013 in the Fourth Affiliated Hospital of Harbin Medical University, including 56 males. The average age was （ 82.09±3.44 ） years-old. The patients were divided into two groups, group A （control group, 20 cases） and group B （treatment group, 66 cases）. The patients in group A were received conventional therapy, and those in group B received conventional therapy and Creatine Phosphate Sodium （2.0 g in 5% glucose solution 100 mL infusion daily）. After admission, the first and second week, recorded two group The serum hs-CRP, Hcy and UA were measured before, 1 and 2 weeks after management and echocardiagrams were performed before and 2 weeks after treatment. Results （ 1 ） Two groups of patients showed difference in clinical effective rate between the A group （75.0%） and the B group （89.4%） forDHF. （2） Afterone week and two weeks treatment the level of serum hs-CRP/HCY/UA have reduced, and reduced evidently in two weeks than admission （hs-CRP： P=0.032; HCY： P=0.021; UA： P〈0.001 ）, And after treatment, HCY/UA of the B group is decreased more significantly than the A group （HCY： P=0.031; UA： P=0.023）. （3） After two weeks treatment, the E, E/A, LVEF, FS of two groups were higher , the A group was lower than admission （LVEF： P〈0.001; FS： P=0.013; E： P=0.024; A： P=0.047; E/A： P〈0.001 ）, and the difference in B group is more obvious than A group （LVEF： P〈0.001; FS： P=0.037; E： P=0.045; A： P〈0.001; E/A： P=0.028）. Conclusion （1） The conventional anti-heart failure therapy with Creatine Phosphate Sodium injection, can significantly improves clinical effective rate and cardiac function in elderly CHD and diastolic heart failure patients. （ 2 ） The therapy decreases the level of serum HCY/UA, and no affection on the level of hs-CRP.