慢性心力衰竭患者经芪苈强心胶囊辅助左西孟旦治疗后心功能及血清脑钠素N端前体肽水平分析

Analysis of Cardiac Function and Serum Brain Natriuretic Peptide N-terminal Precursor Peptide Level in Patients with Chronic Heart Failure after Qili Qiangxin Capsule Assisted Levosimendan Treatment

目的:分析慢性心力衰竭(CHF)患者经芪苈强心胶囊辅助左西孟旦治疗后心功能及血清脑钠素N端前体肽(NT-proBNP)水平。方法:选取商丘市中医院2018年5月至2020年6月期间接收的CHF患者88例作为研究对象,依据随机数字表法分成联合组(44例)以及对照组(44例),其中对照组予以左西孟旦治疗,联合组基于对照组加用芪苈强心胶囊治疗,比较两组临床疗效以及治疗前后心功能指标[左心室射血分数(LVEF)、每搏输出量(SV)、心脏指数(CI)]、实验室指标[NT-proBNP、同型半胱氨酸(Hcy)]、心肌损伤指标[脂蛋白相关磷脂酶A2(LP-PLA2)、人心型脂肪酸结合蛋白(H-FABP)、基质金属蛋白酶抑制剂-1(TIMP-1)]、中医证候积分。结果:联合组总有效率为93.18%(41/44),较对照组77.27%(34/44)高(P<0.05);治疗后两组中医证候积分少于治疗前,联合组少于对照组(P<0.05);治疗后联合组SV、CI、LVEF高于对照组(P<0.05);治疗后联合组血清Hcy、NT-proBNP水平低于对照组(P<0.05);治疗后联合组血清H-FABP、LP-PLA2、TIMP-1水平低于对照组(P<0.05)。结论:芪苈强心胶囊辅助左西孟旦治疗CHF患者,可提高临床疗效,缓解临床症状,改善心功能,并抑制血清NT-proBNP、Hcy水平,减轻心肌损伤。

Objective:To analyze the cardiac function and serum N-terminal pro-brain natriuretic peptide(NT-proBNP)levels in patients with chronic heart failure(CHF)after Qili Qiangxin capsule assisted levosimendan treatment.Methods:A total of 88 CHF patients received in Shangqiu Hospital of Traditional Chinese Medicine from May 2018 to June 2020 were selected as the research objects.According to the random number table method,they were divided into a combination group(44 cases)and a control group(44 cases).The control group was treated with levosimendan,and the combination group was based on the control group plus Qili Qiangxin capsule.The clinical efficacy and cardiac function indexes[left ventricular ejection fraction(LVEF),stroke volume(SV),cardiac index(CI)],laboratory indicators[NT-proBNP,homocysteine(Hcy)],myocardial injury indicators[lipoprotein-associated phospholipase A2(LP-PLA2),heart-type fatty acid-binding protein(H-FABP),tissue inhibitor of metalloproteinase-1(TIMP-1)],TCM syndrome scores before and after treatment were compared between the two groups.Results:The total effective rate of the combination group was 93.18%(41/44),which was higher than that of the control group[77.27%(34/44)](P<0.05).The scores of TCM syndromes in the two groups after treatment were lower than before treatment,and the combination group was lower than the control group(P<0.05).SV,CI and LVEF in the combination group after treatment were higher than those in the control group(P<0.05).After treatment,the serum Hcy and NT-proBNP levels in the combination group were lower than those in the control group(P<0.05).The levels of serum H-FABP,LP-PLA2 and TIMP-1 in the combination group after treatment were lower than those in the control group(P<0.05).Conclusion:Qili Qiangxin capsule assisted levosimendan in the treatment of CHF patients can improve clinical efficacy,relieve clinical symptoms,improve cardiac function,and inhibit serum NT-proBNP and Hcy levels,and reduce myocardial injury.