麝香保心丸联合曲美他嗪对老年冠心病合并心力衰竭患者血管内皮功能及血浆脑钠肽的影响

Effects of Shexiang Baoxin Pills combined with Trimetazidine on Vascular Endothelial Function and Plasma BNP in Elderly Patients with Coronary Heart Disease and Heart Failure

目的探讨麝香保心丸联合曲美他嗪对老年冠心病合并心力衰竭患者血管内皮功能及血浆脑钠肽(BNP)的影响。方法将82例老年冠心病合并心力衰竭患者随机分为两组,对照组予常规治疗及曲美他嗪治疗,治疗组在此基础上联合麝香保心丸治疗,比较两组患者治疗后临床疗效、血浆内皮素(ET)、一氧化氮(NO)及BNP浓度,并比较左室射血分数(LVEF)及左室舒张末期内径(LVEDd)、6min步行距离。结果治疗组治疗总有效率明显高于对照组(P<0.05);治疗后两组患者血浆BNP、血浆ET及LVEDd均明显降低,血浆NO及LVEF、6min步行距离均明显上升,且治疗组上述指标优于对照组(均P<0.05)。结论麝香保心丸联合曲美他嗪治疗老年冠心病合并心力衰竭可通过不同的机制和途径改善患者血管内皮细胞功能及心功能,提高临床疗效。

Objective To investigate the effects of Shexiang Baoxin pills combined with Trimetazidine on vascular endothelial function and plasma BNP in elderly patients with coronary heart disease（ CHD） and heart failure. Methods82 cases of CHD patients with heart failure were randomly assigned to two groups. Control group received routine treatment and Trimetazidine（ 20 mg / time,TID）,observation group received Shexiang Baoxin pills（ 2 pills / time,TID） on the basis of control group. Clinical efficacy,the concentrations of plasma ET,NO and BNP were compared between the two groups after treatment,LVEF,LVEDd,6 min walking distance were also compared. Results The total effective rate of observation group was 92. 68%,significantly higher than 78. 05% of control group,the difference was statistically significant（ P〈 0. 05）; the plasma BNP,ET concentrations and LVEDd were obviously decreased after treatment,plasma NO and LVEF,6 min walking distance were significantly increased,and the indexes of observation group were better than those of control group,the differences were statistically significant（ P〈 0. 05）. Conclusion Shexiang Baoxin pills combined with Trimetazidine can improve vascular endothelial function and heart function through different mechanisms and ways and improve the clinical efficacy in treatment of elderly patients with CHD and heart failure.