芪苈强心胶囊联合单硝酸异山梨酯治疗慢性心力衰竭疗效的评价

Correlation among left ventricular ejection fraction,N-terminal pro-brain natriuretic peptide and curative effect of Qiliqiangxin Capsules combined with Isosorbide Mononitrate Capsules on chronic heart failure

目的探究芪苈强心胶囊联合单硝酸异山梨酯胶囊治疗慢性心力衰竭(CHF)疗效的评价。方法选择2017年1月至2021年1月于长治市中医研究所附属医院收治的经芪苈强心胶囊联合单硝酸异山梨酯治疗的CHF患者118例,按疗效分为有效组和无效组,每组各59例,收集患者一般临床资料,多因素Logistic回归分析影响疗效不同的高危因素,建立ROC曲线分析左室射血分数(LVEF)、N末端脑钠肽前体(NT-proBNP)水平对疗效的评价价值,Pearson相关性分析LVEF、NT-proBNP水平表达与心功能的相关性。结果无效组患者年龄、体质指数(BMI)、收缩压(SBP)、NT-proBNP、左室舒张末期内径(LVEDd)均高于有效组,LVEF低于有效组(P<0.05);多因素Logistic回归分析显示,NT-proBNP水平、LVEF、LVEDd均是影响患者疗效的独立因素(P<0.05)。ROC曲线显示,LVEF、NT-proBNP诊断CHF治疗有效的AUC分别为0.746、0.797,两者联合诊断CHF治疗有效的AUC为0.901,高于单一检测(P<0.05);Spearman相关性分析显示,NYHA分级与LVEF呈负相关(r=-0.634,P<0.001),与NT-proBNP水平呈正相关(r=0.773,P<0.001);Pearson相关性分析显示,NT-proBNP水平与LVEF呈负相关(r=-0.507,P<0.001)。结论LVEF和NT-proBNP水平对芪苈强心胶囊联合单硝酸异山梨酯治疗CHF的病情评估及疗效评价具有一定临床价值。

Objective To analyze the correlation among left ventricular ejection fraction(LVEF),N-terminal pro-brain natriuretic peptide(NT-proBNP)and curative effect of Qiliqiangxin Capsules combined with Isosorbide Mononitrate Capsules on chronic heart failure(CHF).Methods CHF patients(n=118)treated with Qiliqiangxin Capsules combined with Isosorbide Mononitrate Capsules were chosen from the Affiliated Hospital of Changzhi Institute of Traditional Chinese Medicine from Jan.2017 to Jan.2021.All patients were divided,according to curative effect,into effective group and ineffective group(each n=59).The general clinical materials were collected,and risk factors affecting curative effect were analyzed by using multi-factor Logistic regression analysis.A ROC curve was established for analyzing the diagnostic value of LVEF and NT-proBNP to curative effect.The correlation among LVEF,NT-proBNP and heart function was analyzed by using Pearson correlation analysis.Results The body mass index(BMI),systolic blood pressure(SBP),NT-proBNP and left ventricular end-diastolic diameter(LVEDd)were higher,and LVEF was lower in ineffective group than those in effective group(P<0.05).The results of multi-factor Logistic regression analysis showed that NT-proBNP,LVEF and LVEDd were independent factors affecting curative effect(P<0.05).The results of ROC curve analysis showed that AUC of LVEF was 0.746 and AUC of NT-proBNP was 0.797 in predicting curative effect on CHF,and AUC of LVEF combined with NT-proBNP was 0.901(P<0.05).The results of Spearman correlation analysis showed that NYHA classification was negatively correlated to LVEF(r=-0.634,P<0.001),and positively correlated to NT-proBNP(r=0.773,P<0.001).The results of Pearson correlation analysis showed that NT-proBNP was negatively correlated to LVEF(r=-0.507,P<0.001).Conclusion LVEF and NT-proBNP have some clinical value to assessing CHF status and curative effect of Qiliqiangxin Capsules combined with Isosorbide Mononitrate Capsules.