大株红景天注射液联合重组人脑利钠肽治疗充血性心力衰竭的临床研究

Clinical study on Sofren Injection combined with recombinant human brain natriuretic peptide in treatment of congestive heart failure

目的探讨大株红景天注射液联合重组人脑利钠肽治疗充血性心力衰竭的临床疗效。方法选取2015年10月—2017年8月在陕西中医药大学附属医院接受治疗的充血性心力衰竭患者148例,随机分成对照组(74例)和治疗组(74例)。对照组静脉滴注注射用重组人脑利钠肽,首次静脉冲击1.5μg/kg,然后保持滴速7.5μg/(kg·min)。治疗组在对照组的基础上静脉滴注大株红景天注射液,10 m L加入生理盐水250 m L,1次/d。两组患者均连续治疗2周。观察两组的临床疗效,比较治疗前后两组患者超声心动图指标、血清内皮素-1(ET-1)、N-末端脑钠肽前体(NT-pro BNP)和肿瘤坏死因子-α(TNF-α)水平以及6 min步行距离(6MWT)。结果治疗后,对照组的临床总有效率为79.73%,显著低于治疗组的93.24%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组收缩末期内径(LVESD)和左室舒张末期内径(LVEDD)均显著降低,心指数(CI)和左心室射血分数(LVEF)均显著升高,同组比较差异具有统计学意义(P<0.05);且治疗组患者超声心动图指标改善情况明显优于对照组,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者血清ET-1、NT-pro BNP、TNF-α水平明显降低,6MWT明显增加,同组比较差异具有统计学意义(P<0.05);且治疗组患者血清标志物水平和6MWT明显优于对照组,两组比较差异具有统计学意义(P<0.05)。结论大株红景天注射液联合重组人脑利钠肽可显著缓解充血性心力衰竭患者心衰症状,改善心功能,具有一定的临床推广应用价值。

Objective To explore the clinical effect of Sofren Injection combined with recombinant human brain natriuretic peptide in treatment of congestive heart failure. Methods Patients（148 cases） with congestive heart failure in the Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from October 2015 to August 2017 were randomly divided into control（74 cases） and treatment（74 cases） groups. Patients in the control group were iv administered with Recombinant Human Brain Natriuretic Peptide for injection, the first dose of intravenous pulse was 1.5 μg/kg, then at the rate of 7.5 μg/（kg·min）. Patients in the treatment group were iv administered with Sofren Injection on the basis of the control group, 10 mL added into normal saline 250 mL, once daily. Patients in two groups were treated for 2 weeks. After treatment, the clinical efficacy was evaluated, echocardiographic indexes, ET-1, NT-pro BNP, TNF-α and 6 MWT in two groups before and after treatment were compared. Results After treatment, clinical efficacy in the control group was 79.73%, which were significantly lower than 93.24% in the treatment group, and there were differences between two groups（P〈0.05）. After treatment, the LVESD and LVEDD in two groups were significantly decreased, but the CI and LVEF was significantly increased, and the difference was statistically significant in the same group（P〈0.05）. And the improvement of echocardiographic indexes in the treatment group was significantly better than that in the control group, with significant difference between two groups（P〈0.05）. After treatment, the ET-1, NT-pro BNP, and TNF-α levels in two groups were significantly decreased, 6 MWT was significantly increased, there were differences in the same group（P〈0.05）. And these serum markers levels and 6 MWT in the treatment group were significantly better than those in the control group, with significant difference between two groups（P〈0.05）. Conclusion Sofren Injection combined with recombinant human brain natriuretic peptide can significantly relieve heart failure symptoms and improve the cardiac function in treatment of congestive heart failure, which has a certain clinical application value.