参附注射液对急性左心功能不全患者心功能及血浆脑钠肽的影响

Shenfu injection on cardiac function and brain natriuretic peptide in patients with acute left heart failure

目的探讨参附注射液对急性左心功能不全(AHF)患者心功能及血浆脑钠肽(BNP)的影响。方法分析我院60例AHF患者临床资料,随机分为观察组和对照组,各30例。2组给予相应吸氧、卧床休息、低盐饮食;速尿20 mg/次,1次/d静脉推注;硝酸甘油10 mg加0.9%氯化钠注射液250 m L持续泵入,1次/d;地高辛0.125 mg/次,1次/d。观察组在此基础上加用参附注射液60 m L加0.9%氯化钠注射液250 m L静脉滴注,1次/d。2组疗程均为7 d,疗程结束后采用化学发光免疫法检测治疗前后血浆BNP水平,超声心动图测定左室舒张末内径(LVEDD),计算左室射血分数(LVEF),采用Guyatt进行6 min步行实验(6MWT),测定6 min最大步行距离。结果治疗后BNP水平明显降低,观察组优于对照组,有统计学意义(P<0.05);治疗后LVEDD明显减小,LVEF、6MWT明显增加,观察组优于对照组,有统计学意义(P<0.05)。结论参附注射液可提高左心室收缩功能,能有效降低血浆BNP水平,改善心脏功能。

Objective To explore the effect of Shenfu injection on the cardiac function and brain natriuretic peptide（ BNP） in patients with acute left heart failure（ AHF）. Methods A total of 60 AHF patients were randomized into the observation group and the control group with each group 30. The patients in the two groups were given corresponding oxygen inhalation,bed rest,low-salt diet,furosemide,20 mg / time,1time / d,IVP; nitroglycerin（ 10mg） ＋0. 9% sodium chloride（ 250mL）,continuous pumping,1time / d; digoxin,0125 mg / time,1time / d.On this basis,the patients in the observation group were given additional Shenfu injection（ 60mL） ＋ 0. 9% sodium chloride（ 250 m L）,ivgtt,1time / d. Seven-day treatment was regarded as one course. Chemiluminescence immunoassay was used to detect the plasma BNP level before and after treatment. The echocardiography was used to determine LVEDD. LVEF was calculated. Guyatt was used for six minute walk test（ 6MWT）. The maximum 6 min walking distance was determined. Results BNP level after treatment was significantly reduced,and the reduced degree in the observation group was significantly superior to that in the control group（ P〈0.05）. LVEDD after treatment was significantly decreased,but LVEF and 6MWT were significantly increased,those in the observation group were significantly superior to those in the control group（ P〈0.05）. Conclusion Shenfu injection can enhance the left ventricular systolic function,effectively reduce the plasma BNP level,and improve the cardiac function with a satisfying effect.