丹参川芎嗪联合沙库巴曲缬沙坦钠片对慢性心力衰竭患者心功能、血管内皮功能的影响

Effects of Danshen ligustrazine combined with sacubitril valsartan sodium tablets on cardiac function and vascular endothelial function in patients with chronic heart failure

目的观察丹参川芎嗪联合沙库巴曲缬沙坦钠片对慢性心力衰竭患者心功能、血管内皮功能的影响。方法将71例慢性心力衰竭患者按照随机数字表法分为2组,对照组35例予沙库巴曲缬沙坦钠片方法治疗,治疗组35例在对照组治疗基础上予丹参川芎嗪方法治疗。2组均治疗2个月。比较2组治疗前后炎症相关指标[白细胞介素6(IL-6)、超敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)]、心功能指标[左室舒张末期内径(LVEDd)、左室收缩末期内径(LVESd)、左室射血分数(LVEF)]、血管内皮功能指标[一氧化氮(NO)、降钙素基因相关肽(CGRP)、内皮素1(ET-1)]及氧化应激指标[超氧化物歧化酶(SOD)、丙二醛(MDA)]水平变化,并统计2组疗效。结果治疗组总有效率94.44%(34/36),对照组总有效率77.14%(27/35),治疗组临床疗效优于对照组(P<0.05)。2组治疗后IL-6、hs-CRP、TNF-α水平均较本组治疗前降低(P<0.05),且治疗组治疗后均低于对照组(P<0.05)。2组治疗后LVEDd、LVESd均较本组治疗前降低(P<0.05),LVEF均升高(P<0.05),且治疗组治疗后LVEDd、LVESd均低于对照组(P<0.05),LVEF高于对照组(P<0.05)。2组治疗后NO、CGRP水平均较本组治疗前升高(P<0.05),ET-1水平均降低(P<0.05),且治疗组治疗后NO、CGRP水平均高于对照组(P<0.05),ET-1水平低于对照组(P<0.05)。2组治疗后SOD水平均较本组治疗前升高(P<0.05),MDA水平均降低(P<0.05),且治疗组治疗后SOD水平高于对照组(P<0.05),MDA水平低于对照组(P<0.05)。结论丹参川芎嗪联合沙库巴曲缬沙坦钠片可有效提升慢性心力衰竭临床疗效,或与纠正血管内皮功能,抑制心肌重塑相关。

Objective To analyze the effects of Danshen ligustrazine combined with sacubitril valsartan sodium tablets on cardiac function and vascular endothelial function in patients with chronic heart failure(CHF).Methods Totally 71 CHF patients were randomized 1:1 to receive sacubitril valsartan sodium tablets(the control group)or Danshen ligustrazine combined with sacubitril valsartan sodium tablets(the treatment group)for 2 months.The inflammatory responses(interleukin-6[IL-6],hypersensitive C-reactive protein[hs-CRP],tumor necrosis factor-α[TNF-α]),cardiac function(left ventricular end-diastolic diameter[LVEDd],left ventricular end-systolic diameter[LVESd],left ventricular ejection fraction[LVEF]),vascular endothelial function(nitric oxide[NO],calcitonin gene-related peptide[CGRP],endothelin-1[ET-1]),and oxidative stress indexes(superoxide dismutase[SOD],malondialdehyde[MDA])were included as comparisons.The curative effect was assessed.Results After treatment,the total effective rate in the treatment group was better than that in the control group(94.44%[34/36]vs 77.14%[27/35],P<0.05).The levels of IL-6,hs-CRP and TNF-αin groups were decreased when compared with those before treatment(P<0.05),and which were lower in the treatment group than in the control group(P<0.05).LVEDd and LVESd in groups decreased(P<0.05),but LVEF increased(P<0.05),and LVEDd and LVESd in the treatment group were lower than those in the control group(P<0.05),LVEF was higher than that in the control group(P<0.05).The levels of NO,CGRP and SOD in groups were increased(all P<0.05),which were more common in the treatment group(all P<0.05).The levels of ET-1 and MDA in groups were decreased(all P<0.05),and which in the treatment group were more prevalent(all P<0.05).Conclusion For CHF patients,Danshen ligustrazine combined with sacubitril valsartan sodium tablets can effectively improve the clinical efficacy,which may be related to the correction of vascular endothelial function,inhibition of myocardial remodeling and good disease control.