目的 观察丹参多酚酸盐对慢性心力衰竭患者心功能及血浆脑钠肽的影响.方法 将68例慢性心力衰竭患者随机分为对照组(34例)和治疗组(34例).对照组给予慢性心力衰竭常规治疗;治疗组在常规治疗的基础上加用丹参多酚酸盐0.2g加入5％葡萄糖注射液250 ml或0.9％氯化钠注射液250 ml静脉滴注,每日1次,疗程12周.观察两组患者治疗前、后心功能及血浆脑钠肽浓度的变化.结果 治疗组与对照组治疗12周后心功能均明显好转,总有效率分别为91.2％(31/34)和70.6％(24/34),两组比较差异有统计学意义(x2=9.399,P＜0.01).治疗组治疗前左心室射血分数(LVEF)、每搏输出量(SV)、心输出量(CO)分别为(38±6)％、(44.64±11.03) ml、(4.81±1.03) L/min,治疗后分别为(51±8)％、(63.21±11.94) ml、(5.67±1.17) L/min,治疗前、后比较差异均有统计学意义(t值分别为-7.580、-8.975、-3.233,P均＜0.01);治疗组治疗前收缩压、舒张压、心率、舒张末期左心室内径(Dd)、舒张期左心室后壁厚度(PWT)、舒张期室间隔厚度(IVST)、左心室质量(LVMW)、血浆脑钠肽分别为(131 ±11) mmHg、(85±7)mmHg、(116±9)次/min、(55.1±7.9) mm、(11.8±2.4)mm、(11.4±2.3) mm、(231 ±112)g、(572.9±183.6) ng/L,治疗后分别为(104 ±7) mmHg、(76±8)mmHg、(75±7)次/min、(48.8±3.9)mm、(9.2±1.3)mm、(8.9±1.1)mm、(172±57)g、(101.8±18.5) ng/L,治疗前、后比较差异均有统计学意义(t值分别为12.075、4.937、20.961、4.169、5.556、5.721、2.738、14.886,P均＜0.01).对照组治疗前LVEF、SV分别为(37±7)％、(44.87±10.82) ml,治疗后分别为(42±9)％、(56.70±10.60) ml,治疗前、后比较差异均有统计学意义(t值分别为-2.556、-4.554,P均＜0.01);对照组治疗前收缩压、心率、Dd、IVST、血浆脑钠肽分别为(130±12) mmHg、(114±10)次/min、(54.8 ±8.7)mm、(11.3±2.6) mm、(574.1±181.4) ng/L,治疗后分别为(115±9)mmHg、(76±8)次/min、(50.6±8.3) mm、(9.9±1.3)mm、(215.7 ±23.2) ng/L,治疗前、后比较差异均有统计学意义(t值分别为5.830、17.304、2.037、2.806、11.427,P＜0.01或P＜0.05).治疗组治疗后收缩压、舒张压、LVEF、SV、CO、PWT、IVST、脑钠肽明显优于对照组(t值分别为-4.601、-3.093、4.358、3.253、2.802、-3.066、-3.425、-27.985,P均＜0.01).结论 丹参多酚酸盐治疗慢性心力衰竭疗效显著,对左心室有逆转作用,且不良反应少.
目的 觀察丹參多酚痠鹽對慢性心力衰竭患者心功能及血漿腦鈉肽的影響.方法 將68例慢性心力衰竭患者隨機分為對照組(34例)和治療組(34例).對照組給予慢性心力衰竭常規治療;治療組在常規治療的基礎上加用丹參多酚痠鹽0.2g加入5％葡萄糖註射液250 ml或0.9％氯化鈉註射液250 ml靜脈滴註,每日1次,療程12週.觀察兩組患者治療前、後心功能及血漿腦鈉肽濃度的變化.結果 治療組與對照組治療12週後心功能均明顯好轉,總有效率分彆為91.2％(31/34)和70.6％(24/34),兩組比較差異有統計學意義(x2=9.399,P＜0.01).治療組治療前左心室射血分數(LVEF)、每搏輸齣量(SV)、心輸齣量(CO)分彆為(38±6)％、(44.64±11.03) ml、(4.81±1.03) L/min,治療後分彆為(51±8)％、(63.21±11.94) ml、(5.67±1.17) L/min,治療前、後比較差異均有統計學意義(t值分彆為-7.580、-8.975、-3.233,P均＜0.01);治療組治療前收縮壓、舒張壓、心率、舒張末期左心室內徑(Dd)、舒張期左心室後壁厚度(PWT)、舒張期室間隔厚度(IVST)、左心室質量(LVMW)、血漿腦鈉肽分彆為(131 ±11) mmHg、(85±7)mmHg、(116±9)次/min、(55.1±7.9) mm、(11.8±2.4)mm、(11.4±2.3) mm、(231 ±112)g、(572.9±183.6) ng/L,治療後分彆為(104 ±7) mmHg、(76±8)mmHg、(75±7)次/min、(48.8±3.9)mm、(9.2±1.3)mm、(8.9±1.1)mm、(172±57)g、(101.8±18.5) ng/L,治療前、後比較差異均有統計學意義(t值分彆為12.075、4.937、20.961、4.169、5.556、5.721、2.738、14.886,P均＜0.01).對照組治療前LVEF、SV分彆為(37±7)％、(44.87±10.82) ml,治療後分彆為(42±9)％、(56.70±10.60) ml,治療前、後比較差異均有統計學意義(t值分彆為-2.556、-4.554,P均＜0.01);對照組治療前收縮壓、心率、Dd、IVST、血漿腦鈉肽分彆為(130±12) mmHg、(114±10)次/min、(54.8 ±8.7)mm、(11.3±2.6) mm、(574.1±181.4) ng/L,治療後分彆為(115±9)mmHg、(76±8)次/min、(50.6±8.3) mm、(9.9±1.3)mm、(215.7 ±23.2) ng/L,治療前、後比較差異均有統計學意義(t值分彆為5.830、17.304、2.037、2.806、11.427,P＜0.01或P＜0.05).治療組治療後收縮壓、舒張壓、LVEF、SV、CO、PWT、IVST、腦鈉肽明顯優于對照組(t值分彆為-4.601、-3.093、4.358、3.253、2.802、-3.066、-3.425、-27.985,P均＜0.01).結論 丹參多酚痠鹽治療慢性心力衰竭療效顯著,對左心室有逆轉作用,且不良反應少.
목적 관찰단삼다분산염대만성심력쇠갈환자심공능급혈장뇌납태적영향.방법 장68례만성심력쇠갈환자수궤분위대조조(34례)화치료조(34례).대조조급여만성심력쇠갈상규치료;치료조재상규치료적기출상가용단삼다분산염0.2g가입5％포도당주사액250 ml혹0.9％록화납주사액250 ml정맥적주,매일1차,료정12주.관찰량조환자치료전、후심공능급혈장뇌납태농도적변화.결과 치료조여대조조치료12주후심공능균명현호전,총유효솔분별위91.2％(31/34)화70.6％(24/34),량조비교차이유통계학의의(x2=9.399,P＜0.01).치료조치료전좌심실사혈분수(LVEF)、매박수출량(SV)、심수출량(CO)분별위(38±6)％、(44.64±11.03) ml、(4.81±1.03) L/min,치료후분별위(51±8)％、(63.21±11.94) ml、(5.67±1.17) L/min,치료전、후비교차이균유통계학의의(t치분별위-7.580、-8.975、-3.233,P균＜0.01);치료조치료전수축압、서장압、심솔、서장말기좌심실내경(Dd)、서장기좌심실후벽후도(PWT)、서장기실간격후도(IVST)、좌심실질량(LVMW)、혈장뇌납태분별위(131 ±11) mmHg、(85±7)mmHg、(116±9)차/min、(55.1±7.9) mm、(11.8±2.4)mm、(11.4±2.3) mm、(231 ±112)g、(572.9±183.6) ng/L,치료후분별위(104 ±7) mmHg、(76±8)mmHg、(75±7)차/min、(48.8±3.9)mm、(9.2±1.3)mm、(8.9±1.1)mm、(172±57)g、(101.8±18.5) ng/L,치료전、후비교차이균유통계학의의(t치분별위12.075、4.937、20.961、4.169、5.556、5.721、2.738、14.886,P균＜0.01).대조조치료전LVEF、SV분별위(37±7)％、(44.87±10.82) ml,치료후분별위(42±9)％、(56.70±10.60) ml,치료전、후비교차이균유통계학의의(t치분별위-2.556、-4.554,P균＜0.01);대조조치료전수축압、심솔、Dd、IVST、혈장뇌납태분별위(130±12) mmHg、(114±10)차/min、(54.8 ±8.7)mm、(11.3±2.6) mm、(574.1±181.4) ng/L,치료후분별위(115±9)mmHg、(76±8)차/min、(50.6±8.3) mm、(9.9±1.3)mm、(215.7 ±23.2) ng/L,치료전、후비교차이균유통계학의의(t치분별위5.830、17.304、2.037、2.806、11.427,P＜0.01혹P＜0.05).치료조치료후수축압、서장압、LVEF、SV、CO、PWT、IVST、뇌납태명현우우대조조(t치분별위-4.601、-3.093、4.358、3.253、2.802、-3.066、-3.425、-27.985,P균＜0.01).결론 단삼다분산염치료만성심력쇠갈료효현저,대좌심실유역전작용,차불량반응소.
Objective To investigate the effect of salvianolate on chronic heart failure in patients with cardiac function and plasma brain natriuretic peptide effect.Methods Sixty-eight cases with chronic heart failure patients were randomly divided into treatment group and control group (34 cases for each group).Patients in control group were given the conventional treatment,in treatment groups were given conventional treatment plan plus salvianolic acid at dose of 0.2 g added 5％ glucose injection 250 ml (or 0.9％ sodium chloride injection 250 ml),1 times a day for 12 weeks.The cardiac function was recorded and brain natriuretic peptide level was measured before and after treatment.Results After 12 weeks of treatment,the total efficiency in treatment group was 91.2％ (31/34)) higher than that in control group(70.6％ (24/34)),and the difference was statistically significant (x2 =9.399,P ＜ 0.01).Before treatment,the left ventricular ejection fraction (LVEF),stroke volume(SV),cardiac output(CO) in treatment group were (38 ±6)％,(44.64 ± 11.03) ml,(4.81 ± 1.03) L/min respectively,differed from that after treatment ((51 ± 8) ％,(63.21 ± 11.94) ml,(5.67 ± 1.17) L/min),and there were significant differences between before and after treatment (t =-7.580,-8.975,-3.233 respectively; P ＜ 0.01).The levels of systolic blood pressure,diastolic blood pressure,heart rate,left ventricular end-diastolic internal diameter (Dd),the left ventricular diastolic wall thickness (PWT),diastolic interventricular septal thickness (IVST),left ventricular mass (LVMW),brain natriuretic peptide in treatment group before treatment were (131 ± 11) mmHg,(85 ± 7) mmHg,(116 ± 9) times/min,(55.1 ± 7.9) mm,(11.8 ± 2.4) mm,(11.4 ± 2.3) mm,(231 ± 112) g,(572.9 ± 183.6) ng/L respectively,significant differed from those of after treatment((104 ± 7) nmHg,(76 ± 8) mmHg,(75 ± 7) times/min,(48.8 ± 3.9) mm,(9.2±1.3) mm,(8.9± 1.1) mm) (172 ±57) g,(101.8 ± 18.5) ng/L respectively),and the differences were significant (t =12.075,4.937,20.961,4.169,5.556,5.721,2.738,14.886 ; P ＜ 0.01).The levels of LVEF,SV in control group before treatment were (37 ±7)％ and (44.87 ± 10.82) ml,differed from those of after treatment((42 ± 9)％ and (56.70 ± 10.60) ml;t =-2.556,-4.554;P ＜ 0.01).The systolic blood pressure,heart rate,Dd,IVST,plasma brain natriuretic peptide in control group before treatment were (130 ±12) mmHg,(114 ± 10) times/min,(54.8 ± 8.7) rmm,(11.3 ± 2.6) mm,(574.1 ± 181.4) ng/L respectively,significantly differed from those of after treatment ((115 ± 9) mmHg,(76 ± 8) times/min,(50.6 ±8.3) mm)(9.9±1.3) mm,(215.7 ±23.2) ng/L;t=5.830,17.304,2.037,2.806,11.427;P＜0.01 or P ＜ 0.05).The levels of systolic blood pressure,diastolic blood pressure,LVEF,SV,CO,PWT,IVST,plasma brain natriuretic peptide in treatment group were better than that in control group (t =-4.601,-3.093,4.358,3.253,2.802,-3.066,-3.425,-27.985,P＜0.01).Conclusion Salvianolate is proved to be better drug on treating chronic heart failure curative with left ventricular reverse effect and less adverse reaction.
