参麦注射液联合托伐普坦片治疗慢性心力衰竭的效果及对心功能和心肌酶谱表达的影响

Effect of Shenmai injection combined with tolvaptan tablets in the treatment of chronic heart failure and on cardiac function and myocardial enzyme profile expression

目的 观察参麦注射液联合托伐普坦片治疗慢性心力衰竭(CHF)的效果及对心功能和心肌酶谱表达的影响。方法 选取2020年5月—2022年5月安陆市普爱医院收治的CHF患者67例,采用随机数字表法分为研究组34例和对照组33例。对照组给予常规利尿、强心治疗,研究组在对照组基础上给予参麦注射液联合托伐普坦片治疗,2组均治疗4周。比较2组临床疗效,治疗前后心功能指标[左室舒张末期内径(LVEDD)、左房内径(LAD)、左室射血分数(LVEF)]、心肌酶谱表达[肌酸磷酸激酶(CK)、天冬氨酸氨基转移酶(AST)、乳酸脱氢酶(LDH)及羟丁酸脱氢酶(HBDH)]、血清炎性因子[超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、同型半胱氨酸(Hcy)]水平。结果 研究组治疗总有效率为97.06%,高于对照组的75.76%(χ^(2)=4.831,P=0.028)。治疗4周后,2组LVEDD、LAD小于治疗前,LVEF高于治疗前,且研究组减小/升高幅度大于对照组(P<0.01);2组CK、AST、LDH、HBDH水平及血清hs-CRP、TNF-α、Hcy水平均低于治疗前,且研究组低于对照组(P<0.01)。结论 参麦注射液联合托伐普坦片治疗CHF效果显著,可明显改善患者心功能,调节心肌酶谱表达,抑制机体炎性反应。

Objective To observe the effect of Shenmai injection combined with tolvaptan tablets in the treatment of chronic heart failure(CHF)and on cardiac function and myocardial enzyme profile expression.Methods A total of 67 CHF patients admitted to Anlu Puai Hospital from May 2020 to May 2022 were selected and divided into study group(34 cases)and control group(33 cases)by random number table method.The control group was given routine diuretic and cardiotonic treatment,while the study group was given Shenmai injection combined with tolvaptan tablets on the basis of the control group.Both groups were treated for 4 weeks.The clinical efficacy,cardiac function indicators[left ventricular end-diastolic diameter(LVEDD),left atrial diameter(LAD),left ventricular ejection fraction(LVEF)],myocardial enzyme profile expression[creatine phosphokinase(CK),aspartate transaminase(AST),lactate dehydrogenase(LDH)and hydroxybutyrate dehydrogenase(HBDH)],serum inflammatory factors[hypersensitive C-response Protein(hs-CRP),tumor necrosis factor-α(TNF-α),homocysteine(Hcy)]levels before and after treatment were compared between the two groups.Results The total effective rate of the study group was 97.06%,which was higher than 75.76%of the control group(χ^(2)=4.831,P=0.028).After 4 weeks of treatment,LVEDD and LAD were lower than before treatment,LVEF were higher than before treatment in two groups,and the decrease/increase in the study group were greater than those of control group(P<0.01).The levels of CK,AST,LDH,HBDH and serum hs-CRP,TNF-αand Hcy in two groups were lower than before treatment,and the levels in study group were lower than those of control group(P<0.01).Conclusion Shenmai injection combined with tolvaptan tablets has remarkable effect in the treatment of CHF,which can significantly improve the cardiac function,regulate the expression of myocardial enzyme profile and inhibit the inflammatory response of the body.