苦碟子治疗老年射血分数保留的心力衰竭对血清BNP、CGA和CypA水平的影响

Clinical Effects of Kudiezi in Treating the Elderly Suffering Heart Failure with Preserved Ejection Fraction and Its Influence on the Levels of Serum BNP,CGA and CypA

目的:观察苦碟子治疗老年射血分数保留的心力衰竭(heart failure with preserved ejection fraction,HFpEF)的临床疗效,及其对血清脑钠肽(brain natriuretic peptide,BNP)、亲环素A(cyclophilin A,CypA)和嗜铬粒蛋白A(chromogranin A,CGA)水平的影响。方法:选择老年HFpEF患者110例,按照随机数字表法分为观察组和对照组,每组55例。对照组予以曲美他嗪治疗,观察组在对照组治疗的基础上予以苦碟子治疗。观察两组临床疗效,6分钟步行试验(6-minute walk test,6MWT)、QRS波、平面QRS-T夹角、窦性心博R-R间期标准差(sinus heartbeat RR interval standard deviation,SDNN)、R-R间期超出50 ms的搏动次数占比(percent of the number whose difference between adjacent NN interval were more than 50 ms,pNN50)、三角搏动指数(triangular beat index,TI)、左室舒张末期内径和舒张早期(E_(峰)/A_(峰))、末期二尖瓣峰值速度比值(left ventricular end-diastolic diameter,LVEDd)、舒张末期左室后壁厚度(left ventricular posterior wall depth,LVPWTd)、BNP、CGA和CypA水平的变化。结果:观察组总有效率[92.73%(51/55)]高于对照组[76.36%(42/55)](P<0.05);治疗后两组6MWT、SDNN、pNN50、TI和E_(峰)/A_(峰)均较治疗前明显升高(P<0.01),QRS、平面QRS-T夹角、LVEDd、LVPWTD、BNP、CGA和CypA水平较治疗前明显降低(P<0.01),观察组与对照组比较,差异有统计学意义(P<0.01)。结论:苦碟子治疗老年HFpEF疗效确切,可明显改善症状和心功能,其机制可能与降低机体BNP、CGA和CypA水平有关。

Objective:To observe clinical effects of Kudiezi(ixeris sonchifolia hance)in treating the elderly suffering HFpEF and its influence on the levels of BNP,CypA and CGA.Methods:A total of 110 elderly patients were chosen and allocated to the observation group and the control group according to random number table method,55 cases in each group.The control group was treated with trimetazidine,and the observation group with Kudiezi based on Western medicine.To observe clinical effects,6MWT,QRS wave,plane QRS-T included angle,SDNN,pNN50,TI,E_(峰)/A_(峰),LVEDd,LVPWTd,the levels of BNP,CGA and CypA in the two groups.Results:Total effective rate of the observation group was 92.73%(51/55),higher than 76.36%(42/55)of the control group(P<0.05);after treating,6MWT,SDNN,pNN50,TI and E_(峰)/A_(峰)of the two groups increased compared with these before treating(P<0.01),QRS wave,plane QRS-T included angle,LVEDd,LVPWTd,the levels of BNP,CGA and CypA reduced than before treating notably(P<0.01),The difference had statistical meaning between the observation group and the control group(P<0.01).Conclusion:Kudiezi could obtain definite effects in treating the elderly with HFpEF,it could notably improve the symptom and cardiac function of the patients,and its mechanism might be related to lowering the levels of BNP,CGA and CypA.