丹参酮ⅡA对充血性心力衰竭患者的疗效

Curative effect of tanshinone ⅡA in patients with congestive heart failure

目的探讨丹参酮ⅡA对充血性心力衰竭(心衰)患者的疗效。方法入选2015年7月~2016年7月于包头市中心医院心内科治疗的60例充血性心衰患者,其中男性21例,女性39例,年龄41~57(49.53±4.33)岁。随机分为观察组和对照组,每组各30例。同期体检健康者60例纳入正常组。对照组给予常规治疗;观察组在对照组的基础上加用丹参酮ⅡA,连续治疗15 d。正常组于入组时、心衰患者于入院当天和治疗15 d后检测一氧化氮(NO)、N末端脑钠肽前体(NT-pro BNP)、6-酮-前列环素F1a(6-keto-PGF1a)和血管性血友病因子(v WF)水平;使用彩色多普勒超声诊断仪检测左室射血分数(LVEF)。治疗后评价临床疗效。结果观察组和对照组治疗后NO、NT-pro BNP较治疗前下降,LVEF较治疗前升高,差异有统计学意义(P均<0.05)。观察组较对照组治疗后NO、NT-pro BNP下降,LVEF升高,差异有统计学意义(P均<0.05)。正常组NO与LVEF与观察组治疗后比较,差异无统计学意义(P均>0.05)。与治疗前比较,观察组和对照组治疗后6-keto-PGF1a均升高,v WF降低,而观察组变化更明显,差异有统计学意义(P均<0.05)。观察组治疗后与正常组6-keto-PGF1a以及v WF水平比较,差异无统计学意义(P均>0.05)。观察组的临床疗效总有效率为93.33%,明显高于对照组66.67%,差异有统计学意义(P<0.05)。结论加用丹参酮ⅡA治疗充血性心力衰竭能更显著改善心功能及血管内皮细胞功能,疗效可靠,值得推广。

Objective To observe the curative effect of tanshinone ⅡA in patients with congestive heart failure （CHF）. Methods CHF patients （n=60, male 21, female 39, aged from 41 to 57 and average age=49.53±4.33） were chosen from the Department of Cardiology of Central Hospital of Baotou City from July 2015 to July 2016. The patients were randomly divided into observation group and control group （each n=30）, and at the same time 60 health controls were chosen into normal group. The control group was given routine treatment and observation group was additionally given tanshinone ⅡA continuously for 15 d. The levels of nitric oxide （NO）, N-terminal pro-brain natriuretic peptide （NT-proBNP）, 6-keto prostaglandin F1a （6-keto-PGF1a） and vascular Willebrand factor （vWF） were detected in normal group at time of grouping, day of hospitalization and 15 d after treatment. The level of left ventricular ejection fraction （LVEF） was detected by using color Doppler ultrasonic diagnostic apparatus. The clinical efficacy was reviewed after treatment. Results The levels of NO and NT-proBNP decreased and LVEF increased in observation group and control group after treatment （all P〈0.05）. The levels of NO and NT-proBNP decreased and LVEF increased in observation group compared with control group after treatment （all P〈0.05）. The difference in levels of NO and LVEF had no statistical significance between normal group and observation group after treatment （all P〉0.05）. The levels of 6-keto-PGF1a increased and vWF decreased in observation group and control group after treatment, and these changes were more significant in observation group after treatment （all P〈0.05）. The difference in levels of 6-keto-PGF1a and vWF had no statistical significance between normal group and observation group after treatment （all P〉0.05）. The total effective rate was 93.33% in observation group and 66.67% in control group （P〈0.05）. Conclusion Tanshinone ⅡA added into routine therapy can significantly improve heart function and vascular endothelial function with reliable curative effect in patients with CHF.