左西孟旦联合芪苈强心胶囊对老年缺血性心肌病心力衰竭患者作用分析

Therapeutic effects of levosimendan combined with Qiliqiangxin capsule on senile ischemic cardiomyopathy complicated by heart failure

目的探讨左西孟旦联合芪苈强心胶囊对老年缺血性心肌病心力衰竭患者作用分析。方法将2016年8月至2017年8月心内科治疗的96例老年缺血性心肌病心力衰竭患者随机分为2组,每组48例。2组均给予常规药物治疗,在此基础上对照组给予左西孟旦治疗,观察组给予左西孟旦联合芪苈强心胶囊治疗,比较2组患者的临床疗效、左心功能、各项因子水平、不良反应。结果观察组治疗有效率为93.75%,明显高于对照组的72.92%,差异有统计学意义(P<0.05);2组治疗前LVEDD、LVESD、LVEF、LVEDV、LVESV差异无统计学意义(P>0.05);观察组治疗后LVEDD、LVESD、LVEF、LVEDV、LVESV与对照组比较明显改善,差异有统计学意义(P<0.05);2组治疗前NT-pro BNP、hs-CRP、IL-6、TNF-ɑ水平差异无统计学意义(P>0.05);观察组治疗后NT-pro BNP、hs-CRP、IL-6、TNF-ɑ较对照组明显降低,差异有统计学意义(P<0.05);观察组胃肠道反应、低血压、头晕、头痛、室性心动过速等不良反应发生率与对照组比较差异无统计学意义(P>0.05)。结论左西孟旦联合芪苈强心胶囊对老年缺血性心肌病心力衰竭患者治疗效果显著,能有效改善左心功能,抑制心室重构,降低特异性心力衰竭指标水平,减轻全身炎性反应,且不良反应发生率低,具有积极的临床意义。

Objective To observe the therapeutic effects of levosimendan combined with Qiliqiangxin capsule on ischemic cardiomyopathy complicated by heart failure in elderly patients. Methods A total of 96 elderly patients with ischemic cardiomyopathy complicated by heart failure who were treated in our hospital from August 2016 to August 2017 were randomly divided into observation group（n = 48） and control group（n = 48）. The patients in both groups were treated by routine drugs,on this basis,the patients in control group were treated by levosimendan,however,the patients in observation group were treated by levosimendan combined with Qiliqiangxin capsule. The clinical curative effects,left cardiac function,indexes levels and adverse reactions were observed and compared between the two groups. Results The effective rate in observation group was 93. 75%,which was significantly higher than that（72. 92%） in control group（P〈 0. 05）. Before treatment there were no significant differences in the levels of LVEDD,LVESD,LVEF,LVEDV,LVESV between the two groups（P〉 0. 05）. After treatment,LVEDD,LVESD,LVEF,LVEDV and LVESV in observation group were significantly improved,as compared with those in control group（P〈 0. 05）. Before treatment there were no significant differences in the levels of NT-pro BNP,hs-CRP,IL-6,TNF-α between two groups（P〉 0. 05）,after treatment the levels of NT-pro BNP,hs-CRP,IL-6,TNF-α were significantly lower than those in control group（P〈 0. 05）. However there were no significant differnces in the incidence rates of gastrointestinal reaction,hypotension,dizziness,headache,ventricular tachycardia and other adverse reactions between the two groups（P〉 0. 05）. Conclusion Levosimendan combined with Qiliqiangxin capsule has obvious therapeutic effects on ischemic cardiomyopathy complicated by heart failure in elderly patients,which can effectively improve left heart function,inhibit ventricular remodeling,lower the levels of heart failure indexes, relieve systemic inflammatory response,with lower incidence of adverse reactions.