稳心颗粒对心瓣膜病的疗效及胱抑素C、同型半胱氨酸的影响

Wenxin Granule on Cystatin C and Homocysteine and Effect on Heart Valve Disease

目的：探讨稳心颗粒对心瓣膜病的疗效及胱抑素C（CysC）、同型半胱氨酸（Hcy）的影响。方法：将2013年6月—2015年6月医院收治的76例心瓣膜病患者按照随机数字表法分为试验组38例和对照组38例,两组患者均给予常规治疗,试验组在常规治疗基础上给予稳心颗粒,9 g/次,3次/d,两组均连续治疗1个月为1个疗程。分别于治疗前、治疗1个月、3个月、6个月检测两组患者室射血分数（LVEF）、心排血量（CO）、6 min步行试验（6MWT）,采用免疫比浊法检测血清CysC水平,双抗体夹心酶联免疫吸附法检测血清Hcy水平。结果：试验组总有效率94.7%（36/38）;对照组总有效率78.9%（30/38）,试验组总有效率显著高于对照组（χ2=4.145,P=0.042）。治疗1个月、3个月、6个月两组患者LVEF、CO、6-MWT呈上升趋势,其中试验组LVEF、CO、6-MWT上升速度更快,两组在组间、不同时间点、组间×时间点差异均具有统计学意义（P〈0.05）;治疗1个月、3个月、6个月两组患者CysC、Hcy呈降低趋势,其中试验组CysC、Hcy降低速度更快,两组在组间、不同时间点、组间×时间点差异均具有统计学意义（P〈0.05）。两组患者治疗期间均未见严重不良发应,试验组有1例白细胞减少,1例皮疹,血钾轻度升高1例,总不良反应发生率7.9%（3/38）;对照组窦性心律1例,血钾轻度升高1例,总不良反应发生率5.3%（2/38）,两组不良反应发生率比较差异无统计学意义（χ~2=0.214,P=0.644）。结论：稳心颗粒能够提高心瓣膜病的心功能,降低血清CysC、Hcy水平,且不良反应未见增加,安全性较高,值得临床推广。

Objective： To explore the influence on cystatin C and homocysteine and its effect on Wenxin Granule of heart valve disease. Methods： A total of 76 cases of heart valve disease patients treated in hospital from June 2013 to June2015,according to the random number table method,were divided into experimental group 38 cases and control group 38 cases. Two groups were given conventional treatment. The experimental group based on the conventional treatment was given Wenxin Granule,9 g / times,3 times / d. Two groups were treated for 1 month for 1 course. Ventricular ejection fraction（ LVEF）,cardiac output（ CO） and 6-min walk test（ 6MWT） were detected before and 1,3 and 6 months after treatment and the immunoturbidimetry was used to detected serum CysC level. The double antibody sandwich enzyme linked immunosorbent assay（ ELISA） adsorption method was used to detect Hcy level. Results： In experimental group,the total effective rate was 94. 7%（ 36 /38） and the control group’s total effective rate was 78. 9%（ 30 /38）. The experimental group’s total effective rate was significantly higher than that of the control group（ χ2= 4. 145,P = 0. 042）. After 1,3 and6 months treatment,two groups’ LVEF,CO and 6-MWT showed a significant increasing trend and the experimental group’s increased faster. The differences between two groups,in different time points,inter groups × time points had statistical significance（ P 〈 0. 05）. After 1,3 and 6 months treatment,two groups’ CysC and Hcy showed a significant decreasing trend and the experimental group’s decreased more rapidly. The differences between two groups,in different time points,inter groups × time points had statistical significance（ P 〈 0. 05）. During the treatment,the patients in the two groups had no serious adverse reaction. The experimental group had 1 case of leukopenia,1 case of skin rash,1 case of blood potassium slightly increasing. The total incidence rate of adverse reactions was 7. 9%（ 3 /38）. The control group had 1 case of sinus rhythm group,1 case of serum potassium slightly increasing. The total incidence rate of adverse reactions was 5. 3%（ 2 /38） and the adverse reactions of the two groups had no statistically significant（ χ2= 0. 214,P =0. 644）. Conclusion： Wenxin Granule can improve the cardiac function of heart valve disease,reduce serum CysC and Hcy levels. There is no increase in adverse reactions. It has high safety,worthy of promotion.