麝香通心滴丸联合盐酸曲美他嗪对缺血性心力衰竭患者神经激素-细胞因子及左心室重构的影响

Effect of Trimetazidine Combined with Shexiang Tongxin Dropping Pill on Neurohormones-Cytokine and Left Ventricular Remodeling in Patients with Ischemic Heart Failure

目的:探讨麝香通心滴丸联合盐酸曲美他嗪对慢性缺血性心力衰竭(IHF)患者的临床疗效及神经激素-细胞因子和左心室重构的影响。方法:选取2017年3月—2017年12月期间本院收治的172例慢性IHF患者为研究对象,按随机数字表法分为观察组和对照组,两组各86例。对照组患者给予常规西医治疗和盐酸曲美他片,3次/d,1片/次。观察组在此基础上给予麝香通心滴丸,2丸/次,3次/d。两组疗程均为6个月。比较两组治疗前后的肿瘤坏死因子-α(TNF-α)、超敏-C反应蛋白(hs-CRP)、NT-Pro BNP等神经激素-细胞因子水平,以及左心室射血分数(LVEF)、左心室舒张末期内径(LVEDD)、左心室收缩内径(LVESD)、左心室短轴缩短率(FS)、左心室质量指数(LVMI)等左心室重构指标及临床疗效。结果:两组治疗前的基线资料、各神经激素-细胞因子水平、左心室重构指标比较,差异无统计学意义(P> 0. 05),具有可比性。观察组临床总有效率93. 0%,明显高于对照组76. 7%(P <0. 05),观察组治疗后的各神经激素-细胞因子水平、LVEDD、LVESD、LVMI均显著低于对照组,LVEF、FS均显著高于对照组(P <0. 05)。结论:麝香通心滴丸联合盐酸曲美他嗪可显著抑制IHF患者的神经激素细胞因子水平,减轻炎症反应,且能抑制左心室重构,改善心功能,值得临床推广应用。

Objective: To investigate the effect of trimetazidine combined with Shexiang Tongxin Dropping Pill on neurohormones-cytokine and left ventricular remodeling in patients with ischemic heart failure( IHF). Methods: A total of 172 patients with IHF from November 2014 to June 2016 were enrolled the study and randomly divided into observation group and the control group,86 cases in each. Patients in the control group were given conventional treatment and trimetazidine. Based on this,cases in observation group were given Shexiang Tongxin Dropping Pill. The levels of neurohormones-cytokine including factor-α( TNF-α),high-sensitivity C-reactive protein( hs-CRP),N-terminal pronatriuretic peptide( NT-Pro BNP) and left ventricular remodeling indicators including left ventricular ejection fraction( LVEF),left ventricular end-diastolic dimension( LVEDd),left ventricular end systolic diameter( LVESD),fractions shortening( FS),left ventricular mass index( LVMI) were compared between two groups before and after treatment. Results: There were no significant differences in the baseline data,the levels of neurohormones-cytokine or left ventricular remodeling indicators before treatment between two groups( P > 0. 05). The levels of neurohormones-cytokine,LVEDD,LVESD and LVMI in the observation group were significantly lower than those in the control group after treatment( P < 0. 05),and LVEF and FS were significantly higher than those in the control group after treatment( P < 0. 05).Conclusion: Trimetazidine combined with Shexiang Tongxin Dropping Pill could significantly inhibit renin-angiotensin-aldosterone system( RAAS) in patients with IHF,reduce inflammation,inhibit left ventricular remodeling and improve cardiac function,being worthy of clinical popularization and application.