参附注射液联合左西孟旦治疗对慢性心力衰竭患者胃肠激素及心室功能的影响

Shenfu injection combined with levosimendan for treatment of patients with chronic heart failure: Impact on gastrointestinal hormones and heart function

目的探讨参附注射液联合左西孟旦治疗对慢性心力衰竭(chronic heart failure,CHF)患者胃肠激素及心室功能的影响.方法选择2015-10/2016-12收治的CHF患者124例为研究对象,采用随机数字表法分为观察组和对照组各62例.在常规对症治疗的基础上,对照组给予左西孟旦治疗,观察组给予参附注射液联合左西孟旦治疗.治疗2 wk后,比较两组胃肠激素、心室功能、不良反应、临床疗效等指标.结果观察组有效率明显高于对照组(91.94%vs 79.03%,χ~2=4.159,P<0.05);血清胃泌素、胃动素含量明显高于对照组(103.12 ng/mL±14.25 ng/mL vs 91.45ng/mL±12.10 ng/mL,305.62 ng/mL±41.21 ng/mL vs 262.12 ng/mL±35.46 ng/mL,t=4.915、6.300,P<0.05);左心室舒张末期容积、左心室收缩末期容积明显低于对照组,左心室射血分数明显高于对照组(105.45 mL±13.12 mL vs 124.45 mL±16.21 mL,46.25 mL±7.12 mL vs 57.14±7.65 mL,52.45%±7.12%vs 45.12%±7.45%,t=7.174、8.205,5.601,P<0.05);头晕、血压偏低、窦性心动过缓等并发症明显低于对照组(4.84%vs 16.13%,χ~2=4.211,P<0.05).结论参附注射液联合左西孟旦治疗有助于改善CHF患者心室功能,提高临床疗效,减少不良反应发生率,可能与调节患者胃肠激素等因素有关.

AIM To evaluate the effect of Shenfu injection combined with levosimendan on gastrointestinal hormones and heart function in patients with chronic heart failure.METHODS One hundred and twenty-four patients with chronic heart failure treated from October 2015 to December 2016 were randomly divided into either an observation group or a control group. The control group was given leosimendan alone, and the observation group was given levosimendan plus Shenfu injection. Two weeks after therapy, gastrointestinal hormones, heart function, adverse reactions, and clinical efficacy were compared between the two groups. The effective rate was significantly higher in the observation group than in the control group （91.94% vs 79.03%, χ^2 = 4.159, P 〈 0.05）. Serum gastrin and motilin levels were significantly higher in the observation group than in the control group （103.12 ng/mL ± 14.25 ng/mL vs 91.45 ng/mL ± 12.10 ng/mL, 305.62 ng/mL ± 41.21 ng/mL vs 262.12 ng/mL± 35.46 ng/mL, t = 4.915, 6.300, P 〈 0.05）. Left ventricular end-diastolic volume and left ventricular end-systolic volume were significantly lower, and left ventricular ejection fraction was significantly higher in the observation group than in the control group （105.45 mL ± 13.12 mL vs 124.45 mL ± 16.21 mL, 46.25 mL ± 7.12 mL vs 57.14 mL ± 7.65 mL, 52.45% ± 7.12% vs 45.12% ± 7.45%, t =7.174; 8.205, 5.601, P 〈 0.05）. The rate of complications such as dizziness, low blood pressure, and sinus bradycardia was significantly lower in the observation group than in the control group （4.84% vs 16.13%, χ^2 = 4.211, P 〈 0.05）. CONCLUSION Shenfu injection combined with levosimendan can help improve heart function in patients with chronic heart failure, enhance the clinical curative effect, and reduce the adverse reactions, which may be related to regulating gastrointestinal hormones.