心脉隆注射液治疗慢性肺源性心脏病急性加重期的效果及对5-羟色胺的影响

Effect of Xinmailong injection on acute exacerbation of chronic pulmonary heart disease and its effect on serotonin

目的研究心脉隆注射液治疗慢性肺源性心脏病(CPHD)急性加重期患者的临床疗效及对5-羟色胺(5-HT)的影响。方法选择2015年9月-2018年10月衡水市人民医院184例CPHD急性加重期患者,随机分为治疗组与常规组。常规组给予氧疗、基础疾病治疗、强心、利尿等,治疗组同时静滴心脉隆注射液,连续应用10d。观察两组患者的临床疗效及6分钟步行距离(6-MWT),治疗前后肺动脉收缩压(PASP)、肺动脉平均压(MPAP)、左心室射血分数(LVEF);检测治疗前后NT-proBNP、血管生成素-D(Ang-Ⅱ)、5-H T水平。结果治疗组的总有效率明显高于常规组,差异有统计学意义(P<0.05)。治疗前两组患者PASP、MPAP、NT-proBNP、Ang-Ⅱ、5-HT、LVEF及6-MWT的差异均无统计学意义(P>0.05)。治疗后两组各项指标均得到不同程度的改善(P<0.05),而治疗组改善程度均较常规组更加显著(P<0.05)。CPHD病情严重程度与5-HT水平呈正相关,即CPHD患者病情越重,血浆5-HT水平越高。结论心脉隆注射液能有效降低5-羟色胺水平,降低肺动脉高压,迅速缓解CPHD急性加重期患者的临床症状。

Objective To study the clinical effect of Xinmailong in the treatment of acute exacerbation of chronic pulmonary heart disease and its effect on serotonin.Method 184 patients with acute exacerbation of chronic pulmonary heart disease were randomly divided into treatment group and control group.The control group was given oxygen therapy,primary disease treatment,cardioversion and diuretic therapy.The treatment group was treated with intravenous drip of Xinmaolong injection for 10 days.The clinical efficacy and 6-minute walking distance(6-MWT)of the two groups were observed,and the mean(MPAP),left ventricular ejection fraction(LVEF);of pulmonary artery systolic pressure(PASP),and pulmonary artery pressure(PASP),before and after treatment were observed.The levels of NT-proBNP,angiopoietin Ⅱ(Ang-Ⅱ)and 5 hydroxytryptamine(5-HT)were measured before and after treatment.Results The total effective rate in the treatment group was significantly higher than that in the control group,and the difference was statistically significant.There was no significant difference in PASP,mPAP,NT proBNP,Ang-Ⅱ,5-HT,LVEF and 6-MWT between the two groups before treatment(P>0.05).After treatment,the indexes of the two groups were improved in different degrees(P<0.05),and the improvement degree of the treatment group was more significant than that of the conventional group(P<0.05).Correlation analysis showed that there was a positive correlation between the severity of CPHD and the level of 5-HT,that is,the more serious the condition of CPHD,the higher the level of plasma 5-HT.Conclusion Xinmailong can effectively reduce serotonin level,reduce pulmonary hypertension,and rapidly alleviate the clinical status of patients with acute exacerbation of chronic pulmonary heart disease.