心衰参七强心方联合美托洛尔对慢性心力衰竭患者血清NT-proBNP、Nexilin和H-FABP水平的影响

Effects of Shengqi Qiangxin formula for heart failure combined with metoprolol on serum NT-proBNP, Nexilin and H-FABP levels in patients with chronic heart failure

目的 研究心衰参七强心方联合美托洛尔对慢性心力衰竭患者血清N末端脑钠肽前体(NT-proBNP)、结合蛋白(Nexilin)和人心型脂肪酸结合蛋白(H-FABP)水平的影响。方法 选取2018年1月至2020年12月四平市中心人民医院的67例慢性心力衰竭患者,随机分为两组,对照组34例,观察组33例。对照组单用美托洛尔,观察组采用心衰参七强心方联合美托洛尔,均治疗3个月。于治疗后,分析两组有效率。治疗前后,检测两组的血清NT-proBNP、Nexilin和H-FABP水平;且检测左心室舒张末期内径(LVEDD)、左室射血分数(LVEF)、左心室收缩末期容积(LVESV)、心指数(CI)、左心室收缩末期内径(LVESD);统计分析两组治疗后的不良反应。结果 观察组的总有效率明显高于对照组,差异有统计学意义(P <0.05);治疗前,两组的血清NT-proBNP、Nexilin和H-FABP水平比较,差异无统计学意义(P> 0.05),治疗后,两组的血清NT-proBNP、Nexilin和H-FABP水平明显降低,且观察组血清NT-proBNP、Nexilin和H-FABP水平明显低于对照组,差异有统计学意义(P <0.05)。治疗前,两组的LVEDD、LVEF、LVESV、CI、LVESD比较,差异无统计学意义(P> 0.05)。治疗后,两组的LVEDD、LVEF、LVESV、CI、LVESD均明显改善,且观察组的LVEDD、LVEF、LVESV、CI、LVESD明显优于对照组,差异有统计学意义(P <0.05)。两组的心动过缓、头晕、低血压和恶心等不良反应总发生率比较,差异无统计学意义(P> 0.05)。结论 心衰参七强心方联合美托洛尔对慢性心力衰竭患者有显著的疗效,其机制可能与降低血清NT-proBNP、Nexilin和H-FABP水平有关。

Objective To study the effects of Shengqi Qiangxin formula for heart failure combined with metoprolol on the levels of serum N-terminal brain natriuretic peptide precursor(NT-proBNP), binding protein(Nexilin) and human heart-type fatty acid-binding protein(H-FABP) in patients with chronic heart failure(CHF). Methods A total of 67 patients with CHF in Siping Central People’s Hospital from January 2018 to December 2020 were randomly divided into the control group(n=34) and the observation group(n=33) based on the drawing method. The control group was treated with metoprolol alone, while the observation group was treated with Shengqi Qiangxin formula for heart failure combined with metoprolol. Both groups were treated for 3 months. After treatment, the effective rate of treatment of the two groups was analyzed. Before and after treatment, the serum NT-proBNP, Nexilin and H-FABP levels of the two groups were measured, and the left ventricular end-diastolic diameter(LVEDD), left ventricular ejection fraction(LVEF), left ventricular endsystolic volume(LVESV), cardiac index(CI) and left ventricular end-systolic diameter(LVESD) were also measured. The adverse reactions in both groups after treatment were statistically analyzed. Results The total effective rate of treatment in the observation group was significantly higher than that in the control group,with statistically significant differences(P < 0.05). Before treatment, there were no statistically significant differences between the two groups in the serum NT-proBNP, Nexilin and H-FABP levels(P > 0.05). After treatment, the serum NT-proBNP, Nexilin and H-FABP levels in both groups were significantly decreased,and those in the observation group were significantly lower than those in the control group, with statistically significant differences(P < 0.05). Before treatment, there were no statistically significant differences between the two groups in the LVEDD, LVEF, LVESV, CI and LVESD(P > 0.05). After treatment, the LVEDD,LVEF, LVESV, CI and LVESD in both groups improved significantly, and those in the observation group were significantly better than those in the control group, with statistically significant differences(P < 0.05). There was no statistically significant difference between the two groups in the total incidence of adverse reactions such as bradycardia, dizziness, hypotension and nausea(P > 0.05). Conclusion The combination of Shengqi Qiangxin formula for heart failure with metoprolol has significant efficacy in treating patients with CHF, and the mechanism may be related to the reduction of serum NT-proBNP, Nexilin and H-FABP levels.