参松养心胶囊联合富马酸比索洛尔对心力衰竭合并室性早搏的疗效

Effect of Shensong Yangxin Capsules combined with bisoprolol fumarate on heart failure complicated with ventricular premature beats

目的研究参松养心胶囊联合富马酸比索洛尔对心力衰竭(congestive heart failure,CHF)合并室性早搏(premature ventricular contractions,PVC)患者的治疗效果及对血管内皮功能与血清肌酸激酶同工酶(creatine kinase-MB,CK-MB)、肌钙蛋白Ⅰ(cardiac troponinⅠ,cTnⅠ)和肌红蛋白(myoglobin,MYO)水平的影响。方法选择CHF合并PVC患者86例,用随机数字表法均分为对照组和联合组。2组患者均常规给予富马酸比索洛尔治疗,联合组加用参松养心胶囊治疗。比较2组患者的临床疗效、心功能及血管内皮功能,CK-MB、cTnⅠ和MYO的水平等。结果联合组的总有效率为93.02%,显著高于对照组的72.09%(P<0.05)。治疗前,2组的CK-MB、cTnⅠ、MYO、左心室收缩末径(left ventricular end systolic diameter,LVESD)、左心室舒张末径(left ventricular end diastolic diameter,LVEDD)、左心室射血分数(left ventricular ejection fraction,LVEF)、明尼苏达心力衰竭生活质量量表(minnesota heart failure quality of life scale,MLHFQ)评分、6分钟步行距离(6 minutes walk distance,6MWD)和血清N末端脑钠肽(N-terminal brain natriuretic peptide,NT-proBNP)、PVC次数、室性早搏指数(prematurity index,PI)、一氧化氮以及内皮素-l(endothelin-l,ET-1)比较差异均无统计学意义(P>0.05)。治疗后联合组患者的CK-MB、cTnⅠ、MYO、LVESD、LVEDD、MLHFQ、NT-proBNP、ET-1及PVC次数均显著低于对照组,LVEF、6MWD、PI和一氧化氮水平均显著高于对照组(P<0.05)。结论参松养心胶囊联合富马酸比索洛尔可以明显提高CHF合并PVC患者的临床疗效,改善血管内皮功能和心功能,降低心肌损伤标志物的水平,改善患者的临床症状和生活质量,发挥更好的抗PVC作用。

Objective To investigate the effects of Shensong Yangxin Capsules(SYC)combined with bisoprolol fumarate on the therapeutic efficacy,vascular endothelial function and serum levels of creatine kinase-MB(CK-MB),cardiac troponinⅠ(cTnⅠ)and myoglobin(MYO)in patients with chronic heart failure(CHF)complicated with ventricular premature beat(PVC).Methods 86 patients with CHF complicated with PVC were selected and randomly divided into control group and combined group.The both groups were given conventional treatment.On this basis,the control group was given bisoprolol fumarate,while the combined group was given SYC on the basis of control group.The clinical efficacy,cardiac function,vascular endothelial function and CK-MB,cTnⅠand MYO levels of the 2 groups were compared.Results The total effective rate of the combined group was 93.02%,significantly higher than 72.09%of the control group(P<0.05).Before treatment,the levels of CK-MB,cTnⅠ,MYO,left ventricular end systolic diameter(LVESD),left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),and Minnesota heart failure quality of life scale(MLHFQ)scores were obtained for both groups.The 6-minutes walk distance(6MWD),serum N-terminal brain natriuretic peptide(NT-proBNP),PVC frequency,ventricular premature beat index(PI),nitric oxide,and endothelin-l(ET-1)ratios between groups showed no statistically significant difference(P>0.05).After treatment,the CK-MB,cTnⅠ,MYO,LVESD,LVEDD,MLHFQ,NT-proBNP,ET-1,and PVC frequency in the combined group were significantly lower than those in the control group,while the levels of LVEF,6MWD,PI,and nitric oxide in the combined group were higher than those in the control group(P<0.05).Conclusion SYC combined with bisoprolol fumarate can significantly improve the clinical efficacy of CHF patients with PVC,improve vascular endothelial function and cardiac function,reduce the level of myocardial injury markers,improve the clinical symptoms and quality of life of patients,and play a better role in anti-PVC.