地尔硫■联合前列地尔对射血分数保留型心衰患者的疗效观察

Observation of Efficacy of Diltiazem Combined with Alprostadil on Patients with Ejection Fraction Retained Heart Failure

目的:探讨地尔硫联合前列地尔对射血分数保留型心衰(HFpEF)患者的治疗效果。方法:90例HFpEF患者随机分为3组,A组应用常规药物治疗,B组在A组基础上加用地尔硫(静注序贯口服),C组则在B组基础上加用前列地尔注射液静注。比较3组患者治疗前与治疗后6个月的心功能指标、6 min步行试验(6-MWT)、血浆BNP水平变化及临床疗效,采用SF-36量表评价患者治疗前后的生活质量。结果:治疗后C组总有效率明显高于A、B两组(P<0.05)。3组患者治疗后心功能指标均较前明显改善(P<0.05);且C组的左塞收缩末期内径(LVESD)、左塞舒张末期内径(LVEDD)明显低于A组和B组(P<0.05),E值及E/A比值明显高于A组和B组(P<0.05),C组的A值较A组明显改善(P<0.05),然与B组比较差异无统计学意义(P>0.05)。治疗后3组的血浆BNP水平均较前下降,6-MWT和生活质量评分均较前提升(P<0.05);且C组各项指标均明显优于A组及B组(P<0.05)。结论:地尔硫联合前列地尔对于HFpEF患者疗效显著且安全性好,能明显改善患者的心功能和生活质量,值得临床推广使用。

Objective :To investigate the therapeutie effeet of diltiazem combined with alprostadil on patients with ejection fraction retained heart failure ( HFpEF ). Methods: Ninety patients with HFpEF were randomly divided into 3 groups. Group A received conventional dnug therapy. Group B received diltiazem ( intravenous injection sequential oral) on the basis of group A, and group C was treated with alprostadil ( intravenous) on the hasis of group B. The cardiac funetion index, 6 min walk test (6- MWT), plasma BNP level and clinical efficacy were compared before treatment and 6 months after treatment. The quality of life before and after treatment was evaluated by SF-36 scale. Results :The total effective rate of group C afler treatment was significantly higher than the other two groups ( P<0.05). The cardiac function indexes of the three groups were improved (P<0. 05),and the LVESD aund LVEDD o[ the group C were signilfieantly lower than those o[ the group A and the group B (P<0. 05). The E value and the E/ A index of the group C were higher than those of the group A and the group B respectively ( P<0.05), the A value of the group C was signifieantly better than thal of the group A (P <0.05),but there was no statistieal difference compared with the group B ( P>0. 05),After treatment, the plasma BNP values of all three groups decreased , the quality of life scores aund 6-MWT increased ( P<0.05). The various indexes in the group C were significantly 8uperior to those in group A and B ( P<005). Conclusion : Diltiazem combined with alprostadil is efetive and safe for patients with HFpEF , which can significanly improve cardiac function and the quality of life of patients, and is worthy of clinical use.