芪苈强心胶囊联合阿托伐他汀治疗2型心肾综合征疗效及对血清hs-CRP、D-D、ET-1的影响

Effects of Qiliqiangxin capsule combined with atorvastatin on cardiorenal syndrome and its effects on serum hs-CRP,D-D,ET-1

目的观察芪苈强心胶囊联合阿托伐他汀治疗2型心肾综合征(CRS)的疗效及对血清超敏C反应蛋白(hs-CRP)、D-二聚体(D-D)、内皮素-1(ET-1)的影响。方法将98例2型CRS患者随机分为观察组49例和对照组49例,2组均给予强心、利尿、扩管等常规治疗,对照组在常规治疗基础上给予阿托伐他汀钙治疗,观察组在对照组治疗基础上给予芪苈强心胶囊口服,疗程均为12周。观察2组治疗前后心功能(心脏结构功能、心电图)、肾功能、肾动脉血流指标及血清hs-CRP、D-D、ET-1水平变化情况。结果 2组治疗后左室射血分数(LVEF),左室舒张末期内径(LVEDD),N-末端脑钠肽前体(NT-pro BNP)水平,心电图中心室率、QRS波时限、QT间期(QTc),血肌酐(SCr)水平,肾小球滤过率(GFR),血清胱抑素C水平,肾动脉内径(D),肾动脉收缩期峰值血流速度(Vmax),肾动脉阻力指数(RI)较治疗前均明显改善(P均<0.05),且观察组改善情况显著优于对照组(P均<0.05);2组治疗后血清hs-CRP、D-D、ET-1水平均明显降低(P均<0.05),观察组上述指标均显著低于对照组(P均<0.05)。结论芪苈强心胶囊联合阿托伐他汀治疗2型CRS疗效确切,能够显著改善患者的心、肾功能,其机制可能与抑制炎性反应、改善高凝状态以及血管内皮功能有关。

Objective It is to observe the curative effect of Qiliqiangxin capsule with atorvastatin on type 2 cardiorenal syndrome（ CRS） and influence on serum hypersensitive C-reactive protein（ hs-CRP）,D-dimer（ D-D）,endothelin 1（ ET-1）.Methods 98 patients with type 2 CRS were randomly divided into observation group（ 49 cases） and control group（ 49 cases）,both groups were given routine treatment such as strengthening heart,diuresis,tube expanding,additionally,the control group was treated with atorvastatin calcium,while the observation group was given Qiliqiangxin capsule orally on the basis of treatment in control group. Both treatment courses were 12 weeks. The changes of cardiac function（ cardiac structure function,electrocardiogram）,renal function,renal artery blood flow and serum hs-CRP,D-D,ET-1 before and after treatment were observed in both groups. Results After treatment,left ventricular ejection fraction（ LVEF）,left ventricular end-diastolic diameter（ LVEDD）,N-terminal brain natriuretic peptide precursor（ NT-pro BNP）,ventricular rate,time limit of QRS wave and QT interphase（ QTc） in ECG,serum creatinine（ SCr）,glomerular filtration rate（ GFR）,serum Cys-C,renal artery diameter（ D）,renal artery systolic peak velocity（ Vmax）,renal artery blood flow resistance index（ RI） were obviously improved in both groups（ P〈0. 05）,and the improvements of observation group were better than that of control group（ P〈0. 05）. The serum levels of hs-CRP,D-D and ET-1 were significantly reduced after treatment in both groups（ P〈0. 05）,and the above indexes were all lower than those in control group（ P〈0. 05）. Conclusion Qiliqiangxin capsule combined with atorvastatin has good curative effect on type 2 CRS,it can significantly improve the renal and cardiac function of the patients,its mechanism may be related to inhibiting inflammatory reaction,improving high coagulation state and vascular endothelial function.