参芎葡萄糖注射液、前列地尔及无创正压通气联合治疗慢性肺源性心脏病急性加重的临床评价

Clinical Evaluation of Shenxiong Glucose Injection Combined with Alprostadil Injection and Noninvasive Positive Pressure Ventilation in the Treatment of Patients with Acute Exacerbation of Chronic Pulmonary Heart Disease

目的探讨参芎葡糖注射液联合前列地尔及无创正压通气治疗慢性肺源性心脏病急性加重患者的临床疗效。方法选取2016年1月—2016年12月在西南医科大学附属医院呼吸与危重症医学二科住院的慢性肺源性心脏病急性加重患者100例,随机数字表法分为对照组与治疗组各50例。对照组患者予以常规治疗及无创正压通气联合前列地尔10 ug加入0.9%NS100 m L静脉滴注,1次/d。治疗组患者在对照组基础上加用参芎葡萄糖注射液100 m L,静脉滴注1次/d。两组患者治疗14天。比较两组治疗效果、治疗前后动脉血气指标[动脉血氧分压(Pa O2)、动脉血二氧化碳分压(Pa CO2)、动脉血酸碱度(PH)]、肺动脉收缩压(PASP)、氨基末端B型脑利钠肽前体(NT-pro BNP)、血液流变学指标(血浆粘度、全血粘度、纤维蛋白原、红细胞压积)和不良反应。结果治疗总有效率:治疗组92.0%、对照组76.0%,两组差异有统计学意义(P<0.05)。治疗后两组Pa CO2、PASP、NT-pro BNP、血浆粘度、全血粘度、纤维蛋白原及红细胞压积均显著降低,Pa O2、pH值显著升高,同组治疗前后差异显著(P<0.05);治疗组治疗后各指标的改善优于对照组,两组比较差异有统计学意义(P<0.05)。不良反应发生率两组患者无统计学差异(P>0.05)。结论参芎葡萄糖注射液联合前列地尔及无创正压通气治疗慢性肺源性心脏病急性加重临床疗效确切,可有效改善患者动脉血气指标,降低肺动脉压及及血液粘度,且安全性高。

Objective To observe the clinical efficacy of Shenxiong glucose injection combined with alprostadil and noninvasive positive pressure ventilation for patients with acute exacerbations of chronic pulmonary heart dis- ease. Methods 100 patients with acute exacerbation of chronic pulmonary heart disease in the department of respiratory critical care medicine of the affiliated hospital of southwest medical university from January 2016 to December 2016 were randomly divided into control groups 50 cases and treatment groups 50 cases. The patients in the control group were given noninvasive positive pressure ventilation combined with iv administered with alprostadil, 10 ug added into 0. 9% NS 100 mL, once daily. Patients in the observation group were iv administered with Shenxiong glucose injection on the basis of the control group, 100 mL, once daily. Two groups of patients were treated for 14 days. After treatment, the clinical efficacies were evaluated, and arterial blood gas indexes （ PaO2, PaCO2, PH）, PASP, NT - proBNP, blood rheological indexes （blood viscosity, plasma viscosity, fibrinogen, hematocrit） and adverse reactions of two groups were compared. Results The total effective rate of the observation group was 92% and the control group was 76% after treatment, the difference between the two groups was statistically significant （P 〈 0. 05）. PaCO2, PASP, NT - proBNP, blood viscosity, plasma viscosity, fibrinogen and hematocrit of two groups were significantly decreased after treatment, PaO2 and pH were signifi- cantly increased, and the difference was statistically significant in the same group （P 〈 0. 05 ）. The observational indexesin the observation group were significantly better than those in the control group, with significant difference between two groups （ P 〈 O. 05 ）. The incidence of adverse reactions be-tween the two groups was no significant difference （ P 〉 O. 05 ）. Conclusions Shenxiong glucose injection combined with alprostadil and noninvasive positive pressure ventilation has clinical curative effect in treatment of acute exacerbation chronic pulmonary heart disease, can improve arterial blood gas indexes, reduce pulmonary artery pressure and blood vis- cosity.