参附注射液对缺血性心肌病伴急性心力衰竭患者呼气流速峰值的影响

Effects of Shenfu Injection on PEFR of ischemic cardiomyopathy patients with acute heart failure

目的:验证参附注射液治疗急性心力衰竭的临床疗效及急性心力衰竭患者测呼气流速峰值(PEFR值)的临床价值。方法:将入选67例缺血性心肌病伴急性心功能不全患者随机分为参附组33例和常规组34例,参附组在常规组治疗基础上静脉滴注参附注射液(每天1次,每次60m L)。观察治疗前、治疗后第1、3、7天两组患者的血压、尿量、PEFR值、心功能分级、呼吸困难程度评分的变化及临床疗效。结果:治疗期间,参附组患者的血压波动较小,尿量明显增多(P<0.05),呼吸困难显著改善(P<0.01);治疗后第1天,参附组较常规组NTpro BNP水平下降幅度较大(P<0.01);治疗后第7天,参附组较常规组PEFR值明显增加(P<0.05);临床疗效参附组优于常规组(P<0.05)。结论:在西医治疗基础上加用参附注射液治疗缺血性心肌病合并急性心力衰竭患者的疗效优于单纯西药治疗,PEFR可作为一项客观指标用于评价急性心力衰竭患者心功能的变化。

Objective： To verify the clinical effect of Shenfu Injection（SFI） on ischemic cardiomyopathy patients with acute heart failure（ICP-AHF） and evaluate the clinical value of peak expiratory flow rate（PEFR） in these patients. Methods： Sixty-seven ischemic cardiomyopathy patients with acute heart failure were randomly divided into SFI group and control group, 33 cases and 34 cases, respectively. The control group was accepted basic treatment, while the SFI group was accepted the SFI intravenous infusion, 60 m L once a day, combined with the basic treatment. The changes such as blood pressure, urine volume, the value of PEFR, cardiac functional grading, the score of dyspnea degree and clinical effects were observed 24 h before and after the treatment, 3 and 7days after the treatment. Results： Compared with those in the control group, the fluctuation of blood pressure decreased, urine volume significantly increased（P〈0.05）, the degree of dyspnea significantly decreased（P〈0.01）, the level of NT-pro BNP significantly decreased（P〈0.01）, the value of PEFR significantly increased（P〈0.05） in the SFI group, as well as the clinical effects（P〈0.05）. Conclusion： The clinical effect of SFI combined with the basic treatment on ischemic cardiomyopathy patients with acute heart failure is superior to that of single basic treatment. PEFR could be an objective index by which could evaluate the cardiac function of heart failure.