芪苈强心胶囊对缺血性心肌病心力衰竭患者左室重构、心功能、N-末端脑钠肽前体及肌钙蛋白 I的影响

摘要

目的：观察芪苈强心胶囊对缺血性心肌病心力衰竭患者左室重构、心功能、N-末端脑钠肽前体（ NT-proBNP）及肌钙蛋白I（ cTnI）的影响。方法将60例心力衰竭患者随机分为治疗组与对照组各30例，均常规予以血管紧张素转换酶抑制剂或血管紧张素II受体拮抗剂、β受体阻滞剂、利尿剂等治疗，治疗组加用芪苈强心胶囊。治疗6个月后对比观察2组临床症状、左室舒张末期内径（LVEDD）、左室收缩末期内径（LVESD）、左室射血分数（LVEF）、每分钟输出量（ CO）、NT-pro BNP、cTnI等的变化情况。结果治疗组临床总有效率明显高于对照组，差异有统计学意义（93 z．34％vs．80．00％，P＜0．05）。与治疗前比较，2组治疗后NT-proBNP、cTnI、LVEDD均明显降低，LVEF、CO均明显增加，差异有统计学意义（ P ＜0．05或P ＜0．01），而且治疗组治疗后6个月与对照组同期比较NT-proBNP、cTnI水平下降更明显，LVEDD、LVESD、LVEF、CO改善更明显，差异有统计学意义（ P ＜0．05）。治疗组住院时间、再住院率均低于对照组（ P ＜0．05）。结论在心力衰竭常规治疗的基础之上加用芪苈强心胶囊能够降低NT-proBNP、cTnI的水平，逆转左室重构，改善心功能，疗效明显。%Objective To investigate the effect of Qiliqiangxin capsules on left ventricular remodeling , cardiac func-tion, N-terminal pro brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) in patients with ischemic cardio-myopathy and heart failure .Methods Sixty cases of heart failure patients were randomly divided into treatment group and control group with 30 cases in each group , they were given angiotensin converting enzyme inhibitors or angiotensin II receptor antagonists, beta blockers, diuretics, the treatment group added Qiliqiangxin capsules.6 months after treatment, clinical symptoms, left ventricular end-diastolic diameter (LVEDD),Left ventricular end-systolic diameter(LVESD),left ventricular ejection fraction (LVEF), output per minute (CO), changes of NT-proBNP, cTnI were observed and compared between the 2 groups.Results Total effective rate in the treatment group was significantly higher than the control group , the difference was statistically significant (93.33% vs.80.00%, P <0.05).Compared with before treatment , the 2 groups after treat-ment, NT-proBNP, cTnI, LVEDD were decreased , LVEF, CO were increased significantly , the difference was statistically significant ( P <0.05 or P <0.01), and 6 months after treatment, the treatment group's NT-proBNP, cTnI drop obviously, LVEDD, LVESD, LVEF, CO improved obviously compared to the same period in the control group , the difference was statis-tically significant ( P <0.05).The treatment group hospital stay , readmission rates were lower than the control group ( P <0.05).Conclusion For heart failure, on the basis of routine treatment , added Qiliqiangxin capsules could reduce the levels of cTnI, NT-proBNP, reverse left ventricular remodeling , and improve the heart function .