曲美他嗪联合麝香保心丸对老年缺血性心肌病心力衰竭患者血浆B型钠尿肽水平及血清超敏C反应蛋白水平的影响

Impact of Trimetazidine Combined With Shexiang- baoxin Pills on Plasma BNP Level and Serum hs-CRP Level of Aged Patients With Heart Failure Caused by Ischemic Cardiomyopathy

目的探讨曲美他嗪联合麝香保心丸对老年缺血性心肌病心力衰竭患者血浆B型钠尿肽(BNP)及血清超敏C反应蛋白(hs-CRP)水平的影响。方法选取2011年8月—2015年8月湖北省中西医结合医院心内科收治的老年缺血性心肌病心力衰竭患者86例,按治疗方法分为对照组42例与观察组44例。对照组患者予以常规治疗,观察组患者在对照组基础上予以曲美他嗪联合麝香保心丸治疗。比较两组患者临床疗效、治疗前后心功能指标〔左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)〕、6分钟步行距离(6MWD)、血浆BNP水平、血清hs-CRP水平及不良反应发生情况。结果观察组患者临床疗效优于对照组(P<0.05)。治疗前两组患者LVESD、LVEF、6MWD比较,差异无统计学意义(P>0.05);治疗后观察组患者LVESD低于对照组,LVEF高于对照组,6MWD长于对照组(P<0.05)。治疗前两组患者血浆BNP水平、血清hs-CRP水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血浆BNP水平、血清hs-CRP水平低于对照组(P<0.05)。两组患者治疗期间均未发生严重不良反应。结论曲美他嗪联合麝香保心丸治疗老年缺血性心肌病心力衰竭的临床疗效确切,可有效改善患者心功能,降低血浆BNP水平及血清hs-CRP水平,且安全性高。

Objective To investigate the impact of trimetazidine combined with shexiang- baoxin pills on plasma BNP level and serum hs-CRP level of aged patients with heart failure caused by ischemic cardiomyopathy. Methods From August2011 to August 2015, a total of 86 aged patients with heart failure caused by ischemic cardiomyopathy were selected in the Department of Cardiovascular Medicine,Integrated Chinese and Western Medicine Hospital of Hubei Province,and they were divided into control group（ n = 42） and observation group（ n = 44） according to therapeutic methods. Patients of control group received conventional treatment,while patients of observation group received trimetazidine combined with shexiang- baoxin pills based on conventional treatment. Clinical effect, index of cardiac function（ including LVESD and LVEF）,6- minute walk distance,plasma BNP level,serum hs-CRP level and incidence of adverse reactions were compared between the two groups.Results The clinical effect of observation group was statistically significantly better than that of control group（ P〈0. 05）. No statistically significant differences of LVESD, LVEF or 6- minute walk distance was found between the two groups before treatment（ P〈0. 05）; after treatment, LVESD of observation group was statistically significantly lower than that of control group,LVEF of observation group was statistically significantly higher than that of control group,while 6- minute walk distance of observation group was statistically significantly longer than that of control group（ P〈0. 05）. No statistically significant differences of plasma BNP level or serum hs-CRP level was found between the two groups before treatment（ P〈0. 05）,while plasma BNP level and serum hs-CRP level of observation group were statistically significantly lower than those of control group after treatment（ P〈0. 05）. No one of the two groups occurred any serious adverse reactions during the treatment. Conclusion Trimetazidine combined with shexiang- baoxin pills has certain clinical effect in treating aged patients with heart failure caused by ischemic cardiomyopathy,can effectively improve the cardiac function,reduce the plasma BNP level and serum hs-CRP level,and is safe.