参附注射液对心衰患者血清NT-proBNP水平的影响及疗效评价

The Effect and Therapeutic Evaluation of NT-proBNP Level of Patients Treated with Shenfu Injection

目的探讨参附注射液对心肾阳虚型充血性心力衰竭(CHF)患者血清N末端前B型利钠肽(NT-proBNP)水平的影响。方法选择68例心肾阳虚型CHF患者,随机分为常规32例,参附注射液组36例,分别给予常规治疗和在常规治疗基础上参附注射液治疗;两组患者治疗前后均测定或计算血清NT-proBNP、左室射血分数(LVEF)、左室短轴缩短率(FS)、每搏输出量(SV)、心输出量(CO)、心脏指数(CI)及临床征候积分;采用免疫荧光测定法检测血清NT-proBNP浓度。结果血清NTproBNP水平与心衰严重程度呈正相关;治疗后参附注射液治疗组与常规组血清NT-proBNP含量均明显降低,与治疗前相比,有显著性差异(P<0.01),参附注射液组比常规治疗组有一定优势(P<0.05);参附注射液组与常规治疗组治疗后LVEF、FS、SV、CO、CI等心功能指标均有明显改善,与治疗前相比具有非常显著性差异(P<0.01);参附注射液治疗组LVEF、FS、SV、CO较常规治疗组改善更为明显(P<0.05)。两组治疗后心功能分级及中医证候积分均有明显改善(P<0.01),但参附注射液组比常规治疗组更有优势(P<0.05)。结论参附注射液能有效降低心肾阳虚型CHF患者NT-proBNP水平,改善心功能,中西医结合治疗优于常规西医治疗。

Observe The impact of ginseng and aconite injection on the levels of serum N terminal and former b- type natriuretic peptide （NT - proBNP） of patients with Yang deficiency of heart and kidney and congestive heart failure （CHP）. Methods Choose 68 cases of CHF patients with Yang deficiency of heart and kidney, randomly divided into 32 cases of conventional treatment group, and 36 cases of injection treatment group, given conventional treatment and conven- tional with injection treatment respectively. Two groups of patients were measured or calculated serum NT - proBNP, left ventricular ejection fraction （LVEF）, left ventricular short axis shortening rate （FS） output, stroke volume （SV）, cardiac output （CO）, cardiac index （CI） and clinical symptom credits before and after treatment.3, Using immunofluorescence as- say to detect serum NT - proBNP concentration. Results NT -proBNP serum level was posi ively correlated with sever- ity of heart failure. The serum content of NT - proBNP of injection treatment group and conventional therapy group after treatment were obviously lower. Compared with before, the difference （P〈0.01） was very significant, but the injection treatment group has certain advantage than the conventional treatment group （P〈0.05）. LVEF, tFS, SV, CO and CI as cardiac function indexes of injection treatment group and conventional treatment group have markedly improved, compared with treatment before with significant difference （P〈0.01）; LVEF, FS, SV, CO improvement of injection treatment group was more apparent than the conventional treatment group （P〈0.05）. The heart function classification and clinical symptom credits of the two groups were improved significantly （P〈0.01）, but the injection group had more advantages than the con ventional treatment group （P〈0.05）. Conclusion The ginseng and aconite injection can effectively reduce the NT- proBNP level of patients of Yang deficiency of heart and kidney with CHF, improve the heart function. Furthermore, the therapy combining Chinese and western medicine is superior to conventional western medicine.