大株红景天注射液联合美托洛尔对慢性心力衰竭患者氧化应激及心功能的影响

Effects of Rhodiola Crenulate injection combined with Metoprolol on oxidative stress and cardiac function in chronic heart failure

目的 探讨大株红景天注射液联合美托洛尔对心力衰竭患者氧化应激和心功能的影响.方法 采用随机对照研究,将我院2013年10月至2015年4月慢性心力衰竭患者100例随机分成对照组（n=50,给予常规抗心力衰竭治疗）和治疗组（n=50,在常规心力衰竭治疗基础上加用大株红景天注射液和美托洛尔）,用药观察期均为4周.两组患者均于治疗前及治疗后4周观察临床症状改善情况,并通过超声心动图检测左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVESD）及左心室射血分数（LVEF）,实验室检测血浆N-末端脑钠肽前体（NT-proBNP）、丙二醛（MDA）含量及过氧化氢酶（CAT）、超氧化物歧化酶（SOD）活性.结果 治疗组的总有效率（82.0％）明显高于对照组（64.0％）,两组比较差异有统计学意义（P＜0.05）.治疗后两组患者LVEDD、LVESD、血浆MDA和NT-proBNP水平[对照组（56.89±6.21）mm、（36.02±5.75）mm、（6.21±0.55）nmol/ml、（2843.32±1076.63）pg/ml;治疗组（53.28±4.18）mm、（31.88±3.46）mm、（5.23±0.57）nmol/ml、（2256.66±949.76）pg/ml]较治疗前[对照组（62.16±6.95）mm、（41.74±9.29）mm、（7.86±0.80） nmol/ml、（6527.68±2370.48）pg/ml;治疗组（61.46±7.20）mm、（40.76±8.62）mm、（7.91±0.81）nmol/ml、（6491.79±2362.69）pg/ml]显著降低（P＜0.05）,治疗组低于对照组（P＜0.05）.两组患者治疗后LVEF及血浆CAT、SOD[对照组（46.40±7.02）％、（6.54±0.42）U/ml、（46.60±5.40）U/ml;治疗组（49.66±4.42）％、（8.02±0.50）U/ml、（58.66±7.03）U/ml]较治疗前[对照组（32.20±9.28）％、（5.03±0.35）U/ml、（31.62±6.77）U/ml;治疗组（33.08±8.46）％、（5.05±0.34）U/ml、（31.23±5.86）U/ml]均显著提高（P＜0.05）,治疗组高于对照组（P＜0.05）.结论 在常规心力衰竭治疗的基础上加用大株红景天注射液联合美托洛尔能提高心力衰竭患者抗氧化应激能力,改善心功能,临床疗效显著.

Objective To observe effects of Rhodiola Crenutate injection combined with Metoprolol on oxidative stress and cardiac function in chronic heart failure（ CHF ）. Methods The 100 patients with chronic heart failure treated in our hospital from Oct.2013 to Apr.2015 wore randomly divided into control group （n=50, rou-tine treatment） and therapy group （n=50, treated by Rhodiola Crenulate injection condsined with Metoprolol basedon routine treatment）. The observing period was four weeks. To observe the changes of the clinical symptonts and after the study, and the changes of left ventricular end diastolic dimension（LVEDD ）, left ventricular end sys- tolic dimension （LVESD） and left ventricular ejection fraction （LVEF） were detected by Echo cardiography. The levels of N terminal probrain natriuretic（NT-proBNP）, maleic dialdehyde（MDA ）, hydrogen peroxidase（CAT） and superoxide dismutase （SOD） in plasma were measured by chemical method. Results The total effective rate of therapy group（82.0% ） was significantly higher than control group（64.0% ）. There were significant differences be- tween the two groups （P〈0.05）. After four weeks, the LVEDD, LVESD and the plasma levels of MDA and NT- proBNP in two groups [control group （56.89±6.21）mm, （36.02±5.75）mm, （6.21±0.55）nmol/m1, （2843.32± 1076.63 ）pg/ml, therapy group （ 53.28±4.18 ）mm, （ 31.88±3.46 ）mm, （ 5.23±0.57 ）nmol/ml, （ 2256.66±949.76 ） pg/ml] were significantly lower than those before the treatment [control group （62.16±6.95）mm, （41.74±9.29） mm, （7.86±0.80）nmol/ml, （6527.68±2370.48）pg/ml, therapy group （61.46±7.20）mm, （40.76±8.62）mm, （7.91±0.81）nmol/ml, （6491.79±2362.69）pg/ml ] （P〈0.05）, the changes in therapy group were lower than control group （P〈0.05）. Whereas, the LVEF, the plasma levels of CAT and SOD in two groups [control group （46.40±7.02 ）%, （6.54±0.42）U/mI, （46.60±5.40）U/ml, therapy group （49.66±4.42）%, （98.02±0.50）U/ml, （958.66±7.03）U/ml]were significantly increased than those before the treatment [control group （32.20±9.28）%, （5.03± 0.35）U/ml, （31.62±6.77）U/ml, therapy group（33.08±8.46）%, （95.05±0.34）U/ml, （31.23±5.86）U/ml]（P〈 0.05）, the changes in therapy group were higher than control group （P〈0.05）. Conclusion Rhodiola Crenulate injection combined with Metoprolol in CHF patients could effectively enhance anti-oxidative stress ability and im- prove the cardiac function on the basis of conventional treatment. The clinical curative effect is distinct.