疏血通联合依那普利对老年慢性心力衰竭患者血清N末端钠尿肽前体水平、血液流变学与心功能的影响

Effect of Shuxuetong Combined with Enalapril on the Serum N-terminal Natriuretic Peptide Level, Hemorheology and Cardiac Function of Elderly Patients with Chronic Heart Failure

目的:探讨疏血通联合依那普利老年慢性心力衰竭患者血清N末端钠尿肽前体水平、血液流变学与的影响。方法:选择2015年5月到2017年5月我院接诊的老年慢性心力衰竭患者84例作为研究对象,以随机数表法分为观察组(n=42)和对照组(n=42),对照组使用依那普利治疗,观察组采用疏血通联合依那普利治疗。比较两组治疗后的临床疗效及治疗前后血液流变学、血清N末端钠尿肽前体、左室舒张末期内径(LVEDd)、左室射血分数(LVEF)、收缩末期内径(LVESD)水平的变化及不良反应的发生情况。结果:治疗后,观察组临床疗效总有效率显著高于对照组(95.24%vs. 73.81%,P<0.05),观察组全血高切黏度、全血低切黏度、血浆黏度、血沉、红细胞压积及纤维蛋白原水平均明显低于对照组(P<0.05),血清N末端钠尿肽前体水平、LVEDd、LVESD明显低于对照组低(P<0.05),而LVEF显著高于对照组(P<0.05)。两组不良反应总发生率分别为4.76%(2/42)、16.67%(7/42),组间比较无显著差异(P>0.05)。结论:疏血通联合依那普利治疗老年慢性心力衰竭的临床效果显著优于单用依那普利治疗,可能与其显著降低患者的血清N末端钠尿肽前体水平。

Objective: To study the effect of Shuxuetong combined with enalapril on the serum N-terminal natriuretic peptide level,hemorheology and cardiac function of elderly patients with chronic heart failure. Methods: 84 cases of patients with chronic heart failure in our hospital from May 2015 to May 2017 were selected and divided into the observation group(n=42) and the control group(n=42)according to the random number table method, the control group was treated with enalapril, and the observation group was treated with dredged blood and enalapril. The clinical efficacy, changes of N-terminal natriuretic peptide level, hemorheology, left ventricular end-diastolic diameter(LVEDd), left ventricular ejection fraction(LVEF), end systolic diameter(LVESD) level before and after treatment and the occurrence of adverse reactions were compared between two groups. Results: After treatment, the total effective rate of observation group was significantly higher than that of the control group(95.24% vs. 73.81%, P<0.05). The total blood viscosity, total blood viscosity, plasma viscosity, blood sedimentation, erythrocyte deposition and fibrinogen of observation group were significantly lower than those in the control group(P<0.05). The serum N-terminal natriuretic peptide precursor level, LVEDd and LVESD were significantly lower than those of the control group(P<0.05). The LVEF was significantly higher than that of the control group(P<0.05). The total incidence of adverse reactions in two groups were 4.76%(2/42) and 16.67%(7/42) respectively, with no significant difference between the two groups(P>0.05). Conclusion: ShuXieTong combined with enalaprilat was superior to enalaprilat alone in the treatment of elderly patients with chronic heart failure, it could significantly reduce the level of serum N terminal natriuretic peptide precursor, improve the cardiac function and hemorheology.