参附注射液联合左西孟旦治疗急性心力衰竭的临床疗效及其对患者炎性细胞因子和血管内皮细胞功能的影响

Clinical Effect of Shenfu Injection Combined with Levosimendan on Acute Heart Failure and the Impact on Inflammatory Cytokines and Vascular Endothelial Cell Function

目的分析参附注射液联合左西孟旦治疗急性心力衰竭的临床疗效及其对患者炎性细胞因子和血管内皮细胞功能的影响。方法选取肥城矿业中心医院2015年3月—2016年3月收治的急性心力衰竭患者96例,按照随机数字表法分为对照组和观察组,每组48例。在常规治疗基础上,对照组患者给予左西孟旦治疗,观察组患者给予参附注射液联合左西孟旦治疗;两组患者均连续治疗7 d。比较两组患者临床疗效及治疗前后左心室射血分数(LVEF)、脑利钠肽(BNP)水平、血清炎性细胞因子水平、血管内皮细胞功能指标,并观察治疗期间两组患者不良反应发生情况。结果观察组患者临床疗效优于对照组(P<0.05)。治疗前两组患者LVEF和BNP水平比较,差异无统计学意义(P>0.05);治疗后观察组患者LVEF高于对照组,BNP水平低于对照组(P<0.05)。治疗前两组患者血清白介素6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血清IL-6、hs-CRP、TNF-α水平低于对照组(P<0.05)。治疗前两组患者血浆一氧化氮(NO)和内皮素1(ET-1)水平比较,差异无统计学意义(P>0.05);治疗后观察组患者血浆NO水平高于对照组,血浆ET-1水平低于对照组(P<0.05)。治疗期间两组患者均未出现明显药物相关不良反应。结论参附注射液联合左西孟旦治疗急性心力衰竭的临床疗效确切,可有效降低患者血清炎性细胞因子水平,改善患者血管内皮细胞功能,且安全性较高。

Objective To analyze the clinical effect of shenfu injection combined with levosimendan on acute heart failure and the impact on inflammatory cytokines and vascular endothelial cell function. Methods A total of 96 patients with acute heart failure were selected in Feicheng Mining Central Hospital from March 2015 to March 2016,and they were divided into control group and observation group according to random number table, each of 48 cases. Based on conventional treatment,patients of control group received levosimendan, while patients of observation group received shenfu injection combined with levosimendan;both groups continuously treated for 7 days. Clinical effect,LVEF,BNP,serum inflammatory cytokines levels and index of vascular endothelial cell function before and after treatment,and incidence of adverse reactions during the treatment were compared between the two groups. Results Clinical effect of observation group was statistically significantly better than that of control group( P < 0. 05). No statistically significant differences of LVEF or BNP was found between the two groups before treatment( P > 0. 05);after treatment, LVEF of observation group was statistically significantly higher than that of control group,while BNP of observation group was statistically significantly lower than that of control group( P < 0. 05). No statistically significant differences of serum level of IL-6,hs-CRP or TNF-α was found between the two groups before treatment( P > 0. 05),while serum levels of IL-6,hs-CRP and TNF-α of observation group were statistically significantly lower than those of control group after treatment( P < 0. 05). No statistically significant differences of plasma level of NO or ET-1 was found between the two groups before treatment( P > 0. 05);after treatment,plasma NO level of observation group was statistically significantly higher than that of control group,while plasma ET-1 level of observation group was statistically significantly lower than that of control group( P < 0. 05). No one of the two groups occurred any obvious drug related adverse reactions during the treatment.Conclusion Shenfu injection combined with levosimendan has certain clinical effect in treating acute heart failure, can effectively reduce the serum inflammatory cytokines levels and adjust the vascular endothelial cell function,and is relatively safe.