芪苈强心胶囊联合卡托普利对老年高血压合并左室舒张功能不全患者房室重构及血清D-二聚体、hs-CRP、BNP水平的影响

Effect of Qili Qiangxin Capsule combined with captopril on atrioventricular remodeling and serum levels of D-dimer,hs-CRP and BNP in elderly hypertensive patients with left ventricular diastolic insufficiency

目的观察芪苈强心胶囊联合卡托普利对老年高血压合并左室舒张功能不全患者房室重构及血清D-二聚体(D-D)、超敏C反应蛋白(hs-CRP)、B型脑钠肽(BNP)的影响。方法将80例老年高血压合并左室舒张功能不全患者随机分为观察组40例及对照组40例,对照组给予卡托普利治疗,观察组给予卡托普利联合芪苈强心胶囊治疗,疗程6个月;观察2组治疗前及治疗后3个月、6个月房室重构指标、左室舒张功能及血清D-D、hs-CRP、BNP水平变化情况。结果 2组治疗后3个月、6个月左室射血分数(LVEF)、E波峰值流速/A波峰值流速(E/A)明显升高(P均<0.05),左室质量指数(LVMI)、左房容积指数(LAVI)及血清D-D、hs-CRP、BNP水平均显著降低(P均<0.05),且观察组上述指标改善情况均优于对照组(P均<0.05)。2组治疗后3个月、6个月室间隔厚度(IVST)、舒张期左室壁厚度(LVPWT)、左房内径(LA)均明显低于治疗前(P均<0.05),但2组间比较差异均无统计学意义(P均>0.05)。结论芪苈强心胶囊联合卡托普利能够显著抑制老年高血压合并左室舒张功能不全患者房室重构,改善左室舒张功能,可能与二者联合应用可明显下调血清D-D、hs-CRP、BNP的水平有关。

Objective It is to observe the effect of Qili Qiangxin Capsule combined with captopril on atrioventricular remodeling and serum levels of D-dimer （D-D）, hs-CRP and BNP in elderly hypertensive patients with left ventricular diastolic insufficiency. Methods Eighty elderly patients with hypertension and left ventricular diastolic dysfunction were randomly divided into observation group （40 cases） and control group （40 cases）. The control group was treated with captopril and the observation group was treated with Qili Qiangxin Capsule combined with captopril. Both groups were treated for 6 months. The changes of atrioventricular remodeling index, left ventricular diastolic function, serum D-D, hs-CRP, and BNP levels were observed before treatment and after treatment for 3 months and 6 months. Results After treatment for 3, 6 months, LEVF, E/A were significantly increased, LVMI, LAVI and levels of serum D-D, hs-CRP and BNP were significantly decreased in the two groups （ P 〈0.05）, and the improvements of the above indicators in the observation group was better than that in the control group （all P 〈0.05）; IVST, LVPWT and LA were lower than that before treatment in the two groups （ P 〈0.05）, but there was no significant difference in the indexes between the two groups （ P 〉0.05）. Conclusion Qili Qiangxin Capsule combined with captopril can significantly inhibit atrioventricular remodeling and improve left ventricular diastolic function in elderly hypertensive patients with left ventricular diastolic dysfunction, the mechanism may be related with the combination that can significantly reduce serum D-D, hs-CRP and BNP.