磷酸肌酸对充血性心力衰竭患者血浆氨基末端B型脑钠肽前体及心功能的影响

Influence of phosphocreatine on serum N end B type natriuretic peptide and cardiac function in patients with congestive heart failure

目的 探讨磷酸肌酸对充血性心力衰竭(CHF)患者血浆氨基末端B型脑钠肽前体(NT-proBNP)和心功能的影响.方法 将96例CHF患者应用随机数字表分为对照组47例和观察组49例.对照组均给予抗心力衰竭常规治疗,观察组在此基础上联合应用磷酸肌酸治疗,疗程均为4周.比较两组患者治疗后的总有效率和治疗前后左心室舒张末期内径(LVEDD)、左心室收缩末期内径(LVESD)、左心室射血分数(LVEF)以及NT-proBNP水平变化.结果 治疗前两组LVEDD、LVESD、LVEF以及NT-proBNP水平差异均无统计学意义(P均＞0.05);治疗后对照组与观察组患者的LVEDD[(53.5±5.6)、(46.4±4.5) mm]、LVESD[(39.9±5.3)、(34.6±4.8) mm]以及NT-proBNP[(495.8±42.2)、(374.4±38.4)ng/L]较治疗前[(58.3±6.4)、(58.4±6.8) mm,(48.4±6.3)、(48.7±6.2) mm,(875.4±64.8)、(869.2±67.5) ng/L]均明显降低,而LVEF较治疗前明显升高[观察组由(35.8±3.2)％升至(52.6±5.2)％;对照组由(36.4±3.3)％升至(44.5±4.2)％],且观察组的变化较对照组更为明显,差异均有统计学意义(P均＜0.05).观察组总有效率(93.8％,45/49)明显高于对照组(75.0％,36/47),差异有统计学意义(x2=6.836,P=0.037).结论 磷酸肌酸能够有效增强CHF患者的心脏收缩功能,增加LVEF,降低血浆NT-proBNP水平,提高治疗效果.

Objective To discuss the influence of phosphocreatine on serum N end B type natriuretic peptide(NT-proBNP) and cardiac function in patients with congestive heart failure (CHF).Methods Ninetysix patients with CHF were randomly divided into the control group (n =47) and research group (n =49).The patients of the control group were given conventional therapy for treating CHF while the research group were given phosphocreatine based on treatment of the control group,and the course was 4 weeks.The total effective rate and left ventricular end diastolic diameter (LVEDD),left ventricular end systolic diameter (LVESD),left ventricular ejection fraction(LVEF) and NT-proBNP of pretherapy and post-treatment between the two groups were compared.Results There were no statistically significant differences about LVEDD,LVEDD,LVEF and BNP between the two groups (all P＞ 0.05);After treatment,LVEDD in the control group and the observation group patients were (53.5±5.6) mm,(46.4±4.5) mm,LVESD were ((39.9±5.3) mm,(34.6±4.8) mm and NT proBNP were (495.8±42.2) ng/L,(374.4±38.4) ng/L,significantly lower than before treatment ((58.3±6.4) mm,(58.4±6.8) mm;(48.4±6.3) mm,(48.7±6.2) mm;(875.4±64.8) ng/L,869.2 ± ±67.5) ng/L),and LVEF was higher than before treatment significantly (observation group by (35.8±3.2)％ rose to (52.6± 5.2) ％;control group by (36.4± 3.3) ％ rose to (44.5 ± 4.2) ％),and the observation group compared with the control group,the difference was statistically significant(P＜0.05).The total effective rate of research group was evidently higher than that of control group,the difference was statistically significant(93.8％ (45/49) vs.75.0％(36/47);x2=6.836,P=0.037).Conclusion Phosphocreatine can effectively strengthen the heart systolic functionincrease,LVEF,the serum NT-proBNP and enhance the total effective rate of patients with congestive heart failure.