丹参酮ⅡA对充血性心衰患者心功能改善的临床研究

The effect of Tanshinone Ⅱ A on the improvement of cardiac function and protection of endothelial function in patients with congestive heart failure

目的：探究丹参酮ⅡA应用于充血性心衰患者对心功能改善及内皮功能保护的效果。方法： 随机选取在2012年5月~2013年6月期间在我院接收治疗的充血性心衰患者120例作为该研究的对象，对所有的患者进行随机的分组，分为观察组和对照组，对照组的患者选择常规的抗心衰方法进行治疗，观察组的患者在常规组的基础上增加丹参酮ⅡA进行治疗，分别对各组患者治疗前后的左室射血分数、N-末端脑钠素、一氧化氮、6-酮-前列腺素、假血友病因子等进行比较和分析。结果： 健康组参与者与心衰组患者的性别比例、年龄组成以及并发症比较没有显著的差异，与健康组参与者相比较心功能Ⅲ级、Ⅳ级患者的6-keto-PGF1a、NO，LVEF水平有显著差异，两组各项数据比较具有统计学的意义（P〈0.05）；Ⅱ级、Ⅲ级、Ⅳ级患者的vWF、NT-proBNP水平有显著差异，两组各项数据比较具有统计学的意义（P〈0.05）；治疗结束后观察组患者与常规组相比较心功能分级明显的好转，NT-proBNP、vWF、NO较对照组患者明显的降低，LVEF和6-keto-PGF1a水平明显增加，两组患者各项数据比较具有统计学的意义（P〈0.05）；对照组患者的临床有效率为70.00%，观察组患者的临床有效率为91.67%，组间比较差异显著，两组患者各项数据比较具有统计学的意义（P〈0.05）。 结论： 血管内皮功能、6-keto-PGF1a和vWF水平与患者的心衰程度有一定的相关性，参酮Ⅱ能够有效的改善心衰患者的心功能提高治疗的有效率并与患者血管内皮细胞功能的改善有关系。

Objective To investigate the effect of Tanshinone H A on the improvement of cardiac func- tion and protection of endothelial function in patients with congestive heart failure, in order to provide an effective basis for clinical treatment. Methods 129 cases with congestive heart failure were selected from May 2012 to June 2013 in our hospital were as the research object, they were randomly divided into observation group and control group according to the random number table method, the control group were undergone onventional therapy for heart failure conventional, the observation group of patients were given tanshinone on the basis of the the conven- tional group, their clinic data were compared and analyzed respectively, including left ventricular ejection fraction and N-terminal brain natriuretic peptide, nitric oxide, 6- keto prostaglandin, yon Willebrand factor etc. Results There was no significant difference in sex ratio, age composition and complication between healthy group participants and HF group （P〉0.05）. Compared with the healthy group, the levels of 6-keto-PGFlct, NO and LVEF in patients with heart failure were significantly different（P〈0.05 ）, while those in grades H , m and IV. The levels of vWF and NT-proBNP were significantly different between the two groups （P〈0.05）. After treatment, the heart function scores of both groups were significantly improved. The levels of NT-proBNP （4.90±0.2）ng/L, vWF （112±29）% and NO（26.02±13.09）μmol/L in the observation group were significantly lower than those in the control group. The level of PGF1α（68±51 ）ng/L increased significantly（P〈0.05）. The effective rate of the observation group was 91.67%, which was higher than that of the control group（70.00% ）, the difference was statistically significant（P〈0.05 ）. Conclusion There is some correlation between the degree of heart failure and vascular endothelial function, the level of vWF, 6-keto-PGF1α patients, tanshinone can effectively improve cardiac function in patients with heart failure and improve the treatment efficiency and endothelium function.