丹参酮ⅡA磺酸钠对急性心力衰竭患者血流动力学和血管内皮功能的影响

Impact of Tanshinone ⅡA Sulfonic Acid Natrium on Hemodynamics and Vascular Endothelial Function of Patients With Acute Heart Failure

目的探讨丹参酮ⅡA磺酸钠对急性心力衰竭患者血流动力学和血管内皮功能的影响。方法选取2012年东风总医院收治的急性心力衰竭患者98例,按照随机数字表法分为对照组与观察组,每组49例。对照组患者在常规治疗基础上给予美托洛尔治疗,观察组患者在对照组治疗基础上给予丹参酮ⅡA磺酸钠治疗;7 d为1个疗程,两组患者均连续治疗两个疗程。比较两组患者治疗前和治疗24 h后血流动力学指标〔中心静脉压(CVP)、肺循环阻力(PVR)、体循环阻力(SVR)、平均肺动脉压(MPAP)〕,治疗前后心功能指标〔左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、每搏输出量(SV)、左心室射血分数(LVEF)〕和血管内皮功能指标〔内皮素1(ET-1)和一氧化氮(NO)〕,临床疗效及治疗期间不良反应发生情况。结果治疗前两组患者CVP、PVR、SVR、MPAP比较,差异无统计学意义(P>0.05);治疗24 h后观察组患者CVP、PVR、SVR、MPAP低于对照组(P<0.05)。两组患者治疗前后LVEDD、LVESD及治疗前SV、LVEF比较,差异无统计学意义(P>0.05);治疗后观察组患者SV和LVEF高于对照组(P<0.05)。治疗前两组患者血浆ET-1和NO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ET-1水平低于对照组,血浆NO水平高于对照组(P<0.05)。观察组患者临床疗效优于对照组(P<0.05);治疗期间两组患者均未出现严重不良反应。结论丹参酮ⅡA磺酸钠治疗急性心力衰竭的临床疗效确切,能有效改善急性心力衰竭患者血流动力学及血管内皮功能,且安全性较高。

Objective To investigate the impact of tanshinone Ⅱ A sulfonic acid natrium on hemodynamics and vascular endothelial function of patients with acute heart failure. Methods A total of 98 patients with acute heart failure were selected in Dongfeng General Hospital in 2012,and they were divided into control group and observation group according to random number table,each of 49 cases. Based on conventional treatment,patients of control group were given metoprolol,while patients of observation group were given tanshinone ⅡA sulfonic acid natrium;both groups continuously treated for two courses （7 days as a course）. Hemodynamic index（including CVP,PVR,SVR and MPAP）before treatment and after 24 hours of treatment,index of cardiac function（including LVEDD,LVESD,SV and LVEF） and index of vascular endothelial function （including ET-1 and NO） before and after treatment,clinical effect and incidence of adverse reactions during treatment were compared between the two groups. Results No statistically significant differences of CVP,PVR,SVR or MPAP was found between the two groups before treatment（P ﹥ 0. 05）,while CVP,PVR,SVR and MPAP of observation group were statistically significantly lower than those of control group after 24 hours of treatment（P ﹤ 0. 05）. No statistically significant differences of LVEDD,LVESD,SV or LVEF was found between the two groups before treatment,nor was LVEDD or LVESD between the two＆nbsp;groups after treatment（P ﹥ 0. 05）,while SV and LVEF of observation group were statistically significantly higher than those of control group after treatment（P ﹤ 0. 05）. No statistically significant differences of plasma level of ET-1 or NO was found between the two groups before treatment （ P ﹥ 0. 05 ）;after treatment,plasma ET-1 level of observation group was statistically significantly lower than that of control group,while plasma NO level of observation group was statistically significantly higher than that of control group（P ﹤ 0. 05）. The clinical effect of observation group was statistically significantly better than that of control group（P ﹤ 0. 05）;no one of the two groups occurred any severe adverse reactions during the treatment. Conclusion Tanshinone Ⅱ A sulfonic acid natrium has certain clinical effect in treating patients with acute heart failure,can effectively improve the hemodynamics and vascular endothelial function,has relatively high safety.