丹红注射液对慢性心力衰竭患者纤维蛋白原和D-二聚体浓度的影响

Impacts of Danhong Injection on the Concentrations of Fibrinogen and D-Dimeride in the Patients of Chronic Heart Failure

目的观察丹红注射液对慢性充血性心力衰竭(CHF)患者纤维蛋白原和D-二聚体(D-D)浓度的影响。方法 CHF组:选择62例CHF患者,包括冠心病32例,高血压性心脏病17例,心肌病13例(扩张型心肌病8例,肥厚型心肌病5例)。另外选择43例年龄、性别与CHF组相匹配的健康受试者作为对照组。CHF组患者在给予利尿剂、血管紧张素转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂(ACEI/ARB)、β受体阻滞剂和洋地黄制剂等心衰常规治疗1周后,给予0.9%氯化钠注射液250 ml+丹红注射液40 ml,1次/d,疗程1周。测定血浆纤维蛋白原(FG)和D-D浓度。结果1.CHF组患者血浆FG和D-D水平明显高于对照组(P<0.01)。不同NYHA心功能分级间FG和D-D水平存在显著差别,心功能越差,FG和D-D水平越高(P<0.05,P<0.01)。2.常规治疗后,在NYHAⅡ级和Ⅲ级患者,FG和D-D显著低于治疗前(P<0.05);丹红治疗后,FG和D-D显著低于治疗前及常规治疗后(P<0.05,P<0.01)。在NYHAⅣ级患者,常规治疗后和丹红治疗后FG、D-D显著低于治疗前(P<0.05,P<0.01);FG、D-D浓度在常规治疗后及丹红治疗后比较,差异无统计学意义(P>0.05)。结论 CHF患者FG和D-D水平升高,并且与心功能状态有关。CHF患者在使用ACEI/ARB、β受体阻滞剂的基础上,给予丹红注射液治疗,FG和D-D水平降低,有可能改善CHF患者纤溶状况,从而有可能降低血栓栓塞事件的发生。

Objective To observe the impacts of danhong injection on the concentration of fibrigonen( FG) and D- dimeride( D- D) in the patients of chronic heart failure( CHF). Methods In a CHF group,62 cases of CHF were selected,including 32 cases of coronary heart disease,17 cases of hypertensive cardiac disease and 13 cases of cardiomyopathy( 8 cases of dilated cardiomyopathy and 5 cases of hypertrophic cardiomyopathy). Additionally,43 cases of heathy receptors,with age and gender marched with CHF group were collected as the control group. In CHF group,the routine medication for heart failure was used such as diuretics,angiotensin converting enzyme inhibitor / angiotensin II receptor antagonist( ACEI / ARB),beta receptor blocker and digitadis preparation. One week later,0. 9% Na Cl injection 259 ml and danhong injection40 ml were given,once a day,for the other 1 week. The concentrations of FG and D- D were determined. Results 1. In CHF group,the plasma FG and D- D levels were higher apparently than those in the control group( P < 0. 01). The levels of FG and D- D were different significantly among different NYHA cardiac function grades. The poorer the heart function was,the higher the levels of FG and D- D were( P < 0. 05,P <0. 01). 2. After routine treatment,for the patients of NYHA II and III,FG and D- D were reduced significantly as compared with those before treatment( P < 0. 05). After treatment with danhong injection,the levels were lower significantly as compared with those before treatment and after routine treatment( P < 0. 05,P <0. 01). For the patients of NYHA IV,after routine treatment and danhong injection,FG and D- D levels were lower significantly than those before treatment( P < 0. 05,P < 0. 01). But the difference was not significant between the routine treatment and danhong injection( P > 0. 05). Conclusion The concentrations of FG and D- D are increased in CHF patients,which is related with heart function. On the basis of ACEI / ARB and beta receptor blocker,danhong injection reduces FG and D- D concentration and possibly improves in fibrinolysis. As a result,the incidence of thrombosis may be reduced.