心脉隆注射液联合米力农治疗慢性充血性心力衰竭的临床研究

Clinical study on Xinmailong Injection combined with milrinone in treatment of chronic congestive heart failure

目的探讨心脉隆注射液联合米力农注射液治疗慢性充血性心力衰竭的临床效果。方法选取2016年6月—2017年10月安徽省第二人民医院收治的慢性充血性心力衰竭患者88例作为研究对象,采取随机数字表法将患者分为对照组(44例)和治疗组(44例)。对照组静脉注射米力农注射液,先以50μg/kg为首次剂量,用生理盐水20 m L充分稀释后给药,10min缓慢静脉注射完毕,继以0.5μg/(kg·min)持续静脉输注4 h。治疗组在对照组治疗的基础上静脉滴注心脉隆注射液,5 mg/kg加入生理盐水200 m L中均匀混合后给药,滴速20~40滴/min,2次/d(间隔>6 h)。两组均连续治疗7 d。观察两组临床疗效,同时比较治疗前后两组患者症状评分、心功能相关指标、C反应蛋白(CRP)、中性粒细胞/淋巴细胞比值(NLR)、明尼苏达心衰生活质量量表(MLHFQ)评分。结果治疗后,对照组和治疗组临床有效率分别为77.3%和93.2%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者心悸、疲倦乏力、气短、面肢浮肿、胸闷(痛)评分和总分均显著降低,同组治疗前后比较差异有统计学意义(P<0.05);且治疗后治疗组评分显著低于对照组,两组比较差异有统计学意义(P<0.05)。治疗后,两组血浆B型利钠肽(BNP)、心肌肌钙蛋白I(c Tn I)水平均显著降低,左室射血分数(LVEF)、6 min步行距离(6 MWD)值均显著升高,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组心功能相关指标改善更显著,两组比较差异具有统计学意义(P<0.05)。治疗后,两组血清CRP水平、外周血NLR值、MLHFQ评分均显著下降,同组治疗前后比较差异具有统计学意义(P<0.05);且治疗后治疗组CRP、NLR和MLHFQ评分显著低于对照组,两组比较差异具有统计学意义(P<0.05)。结论心脉隆注射液联合米力农注射液治疗慢性充血性心力衰竭疗效确切,能明显缓解症状,改善心功能,减轻炎性损伤,提高生活质量,具有一定的临床推广应用价值。

Objective To investigate the clinical effect of Xinmailong Injection combined with Milrinone Injection in treatment of chronic congestive heart failure. Methods Patients（88 cases） with chronic congestive heart failure in Anhui Second People’s Hospital from June 2016 to October 2017 were randomly divided into the control group（44 cases） and the treatment group（44 cases）. Patients in the control group were iv administered with Milrinone Injection, the first dose was 50 μg/kg, added into normal saline 20 m L, the slow intravenous injection was completed in 10 min, then maintained with 0.5 μg/（kg·min） for 4 h. Patients in the treatment group were iv administered with Xinmailong Injection on the basis of the control group, 5 mg/kg added into normal saline 200 m L, the drop speed was 20 — 40 drops/min, twice daily（ interval time 〉 6 h）. Patients in two groups were treated for 7 d. After treatment, the clinical efficacy was evaluated, and the symptom scores, the cardiac function related indexes, CRP, NLR, and MLHFQ scores in two groups before and after treatment were compared. Results After treatment, the clinical efficacy in the control and treatment group were 77.3% and 93.2%, respectively, and there were differences between two groups（P 〈 0.05）. After treatment, the symptom scores of palpitation, fatigue, shortness of breath, puffy face and swollen limbs, chest tightness（pain）, and the total scores in two groups were significantly decreased, and there were differences in the same group（P 〈 0.05）. After treatment, the symptom scores in the treatment group were lower than those in the control group, and there were differences between two groups（P 〈 0.05）. After treatment, BNP and c Tn I in two groups were significantly decreased, but LVEF and 6 MWD in two groups were significantly increased, and the difference was statistically significant in the same group（P 〈 0.05）. And the cardiac function related indexes in the treatment group were significantly better than those in the control group, with significant difference between two groups（P 〈 0.05）. After treatment, CRP, NLR, and MLHFQ scores in the two groups were significantly decreased, and there were differences in the same group（P 〈 0.05）. After treatment, CRP, NLR, and MLHFQ scores in the treatment group were lower than those in the control group, and there were differences between two groups（P 〈 0.05）. Results Xinmailong Injection combined with Milrinone Injection has significant clinical effect in treatment of chronic congestive heart failure, can significantly relieve symptoms, improve the cardiac function, reduce inflammatory injury, and improve quality of life, which has a certain clinical application value.