诺迪康胶囊联合米力农治疗慢性充血性心力衰竭的临床研究

Clinical study on Nuodikang Capsules combined with milrinone in treatment of chronic congestive heart failure

目的探讨诺迪康胶囊联合米力农治疗慢性充血性心力衰竭的临床效果。方法选取2015年6月—2018年6月郑州大学第一附属医院收治的慢性充血性心力衰竭患者280例,随机分成对照组(140例)和治疗组(140例)。对照组静脉注射米力农注射液,首剂量50μg/kg,给药时间>10 min,然后以0.5μg/(kg·min)持续静脉输注4 h。治疗组在对照组基础上口服诺迪康胶囊,2粒/次,3次/d。两组患者均治疗14 d。观察两组患者临床疗效,同时比较治疗前后两组患者心功能参数、血液流变学指标和GMP-140及一氧化氮(NO)、内皮素-1(ET-1)和血管性血友病因子(v WF)水平。结果治疗后,对照组临床有效率为84.3%,显著低于治疗组的93.6%,两组比较差异具有统计学意义(P<0.05)。治疗后,两组患者左室射血分数(LVEF)值较治疗前显著升高(P<0.05),左室舒张末期内径(LVEDD)、左室收缩末期内径(LVESD)值和血清心肌肌钙蛋白T(cTnT)浓度及血浆B型利钠肽(BNP)水平均显著降低(P<0.05),且治疗组患者心功能明显好于对照组(P<0.05)。治疗后,两组患者血浆黏度(PV)和红细胞聚集指数(EAI)值及血浆血小板α颗粒膜蛋白-140(GMP-140)水平均显著降低(P<0.05),且治疗组患者PV值、EAI值和GMP-14水平明显低于对照组(P<0.05)。治疗后,两组患者血管内皮功能指标NO、ET-1和vWF血浆浓度均显著降低(P<0.05),且治疗组NO、ET-1和vWF血浆浓度明显低于对照组(P<0.05)。结论诺迪康胶囊联合米力农治疗慢性充血性心力衰竭能有效控制患者心衰病情,改善心功能及血流变状态,抑制血小板活性,解除内皮功能障碍。

Objective To explore the clinical effect of Nuodikang Capsules combined with milrinone in treatment of chronic congestive heart failure.Methods Patients (280 cases) with chronic congestive heart failure in the First Affiliated Hospital of Zhengzhou University from June 2015 to June 2018 were randomly divided into control (75 cases) and treatment (75 cases) groups.Patients in the control group were iv administered with Milrinone Injection,the first dose was 50 μg/kg,the administration time was more than 10 min,then continuous intravenous infusion for 4 h with 0.5 μg/(kg·min).Patients in the treatment group were po administered with Nuodikang Capsules on the basis of the control group,2 grains/time,three times daily.Patients in two groups were treated for 14 d.After treatment,the clinical efficacy was evaluated,and the cardiac function parameters,the hemorheological indexes and GMP-140,NO,ET-1,and VWF in two groups before and after treatment were compared.Results After treatment,the clinical efficacy in the control group was 84.3%,which was significantly lower than 93.6% in the treatment group,and there were differences between two groups (P < 0.05).After treatment,the LVEF value in two groups was significantly increased (P < 0.05),but LVEDD,LVESD,serum cTnT concentration and plasma BNP content were significantly decreased (P < 0.05),and the cardiac function in the treatment group was significantly better than those in the control group (P < 0.05).After treatment,the PV value,EAI value,and plasma GMP-14 levels in two groups were significantly decreased (P < 0.05),and which in the treatment group were significantly lower than those in the control group (P < 0.05).After treatment,the plasma concentration of NO,ET-1 and vWF in two groups was significantly decreased (P < 0.05),and which in the treatment group was significantly lower than those in the control group (P < 0.05).Conclusion Nuodikang Capsules combined with milrinone in treatment of chronic congestive heart failure can effectively control the heart failure,improve the heart function and hemorheology,inhibit the platelet activity and relieve endothelial dysfunction.