参麦注射液联合左卡尼汀治疗慢性肺源性心脏病疗效及对血清APN、CPN、IL-6、TNF-α水平的影响

Therapeutic effect of Shenmai injection combined with levocarnitine on chronic pulmonary heart disease and the effect on serum APN,CPN,IL-6 and TNF-α levels

目的观察参麦注射液联合左卡尼汀治疗慢性肺源性心脏病(CPHD)疗效及对血清脂联素(APN)、和肽素(CPN)、白介素-6(IL-6)、肿瘤坏死因子(TNF-α)水平的影响。方法选取2013年1月—2014年10月河北北方学院附属第一医院老年科收治的CPHD心力衰竭期患者110例,按随机数字表法分为观察组55和对照组55例,2组均给予吸氧、祛痰平喘、强心、利尿剂、扩血管等常规治疗,对照组加用左卡尼汀3 g,1次/d,连续治疗3周;观察组在对照组基础上加用参麦注射液100 ml,1次/d,连续治疗3周。观察2组治疗效果及治疗前、后左室舒张功能、血气及血清APN、CPN、IL-6、TNF-α水平的变化。结果观察组总有效率为94.55%(52/55),高于对照组的83.64%(46/55)(x^2=4.928,P<0.05)。2组治疗3周后E峰、Ve明显升高,A峰、Va明显降低,E/A、Ve/Va值升高,差异有统计学意义(P<0.05),且除Ve/Va值外,观察组其他指标较对照组变化更显著(P<0.05)。2组治疗3周后PaO_2、PaCO_2明显好转;血清CPN、IL-6、IL-8水平显著下降,而APN水平明显上升,且观察组更为显著,差异均有统计学意义(P<0.05)。结论参麦注射液联合左卡尼汀能明显改善CPHD心力衰竭期患者临床症状,降低血清CPN、IL-6及TNF-α水平,提高血清APN水平,因而推荐联合应用。

Objective To observe the effect of Shenmai injection combined with levocarnitine in treatment of chronic pulmonary heart disease（CPHD） and effect on serum adiponectin（APN）,and peptide hormone（CPN）,interleukin-6（IL-6） and tumor necrosis factor（TNF-α） levels.Methods From January 2013 to October 2014,selected 110 cases of CPHD heart failure patients who treated in First Affiliated Hospital of Hebei North University,according to the random number table,they were divided into the observation group（55 cases） and the control group（55 cases）,two groups were given oxygen,expectorant and antiasthmatic,strong heart,diuretic and vasodilator conventional therapy,while the control group was treated with L-camitine 3 g,1 times/day,3 weeks of continuous treatment;the observation group based on the treatment of the control group,also added Shenmai injection 100 ml,once daily,continuous treatment for 3 weeks.The therapeutic effect of the two groups before and after treatment,left ventricular diastolic function,blood gas analysis and serum APN,CPN,IL-6 and TNF-α level changes were recorded and compared.Results The total efficiency of observation group was 94.55%（52/55）,which was higher than that of the control group＇s 83.64%（46/55）（χ~2 =4.928,P〈0.05）.Two groups after 3 weeks of treatment,e peak,Ve increased significantly,the peak A and Va significantly reduced,Ve / Va and E / A value increasing,besides Ve / Va,observation group＇s other indicators changed more significantly than that in the control group（P〈0.05）.PaO2,PaCO2 improved in both of the two groups after 3 weeks of treatment;serum CPN,IL-6,IL-8 level decreased significantly,and APN levels were significantly increased,and the observation group＇s changes were more significant,the difference had statistical significance（P〈0.05）.Conclusion It demonstrated that the Shenmai injection combined with levocarnitine can significantly improve the clinical symptoms of the patients with CPHD combined heart failure and decreased serum CPN,IL-6 and TNF-α levels,and increased serum APN level,so it is recommended to combined application.