黄芪注射液对老年高血压患者左室肥厚和左室功能的影响  

Effect of Astragalus injection on cardiac hypertrophy and left ventricular function in elderly patients with essential hypertension

作　　者：沈利亚[1] 汪湛[1] 罗瑛[1] 仇克难[1] 庞贝[1] 胡述雁[1] 梅凡[1] 沈凌云[1] 

机构地区：[1]江汉大学附属医院,湖北武汉430015

出　　处：《中国医院药学杂志》2010年第9期778-781,共4页Chinese Journal of Hospital Pharmacy

摘　　要：目的:应用多普勒超声心动图评价黄芪注射液对老年原发性高血压患者左室肥厚(LVH)的逆转作用,应用心肌作功指数(Tei指数)评价黄芪注射液对左室功能的改善作用。方法:60例患者随机分为治疗组和对照组,2组患者均给予口服非洛地平缓释片5mg,qd;治疗组再选用黄芪注射液30mL,qd,静脉滴注,疗程6周。治疗前、后测定左室室壁厚度和收缩舒张功能,并根据等容舒张期和等容收缩期之和与射血期的比值计算Tei指数。结果:LVH患者经黄芪注射液治疗后左室质量指数降低,由治疗前的(161±36)g.m-2降至治疗后的(137±21)g.m-2,P<0.05。2组射血分数均在正常范围,治疗后二尖瓣舒张早期E峰加速度均显著增加,治疗组和对照组分别为(586.5±173.9)cm.s-2和(742.2±199.8)cm.s-2;(649.1±199.4)cm.s-2和(798.3±227.3)cm.s-2,均为P<0.01。治疗组患者治疗后等容舒张时间和射血时间改善,分别为(118.6±23.8)ms和(93.3±23.4)ms;(255.9±36.2)ms和(292.3±35.7)ms,均为P<0.01。Tei指数由(0.58±0.11)降至(0.43±0.09)(P<0.01)。结论:黄芪注射液对左室肥厚有逆转作用,能改善心肌的顺应性,有效改善老年高血压患者的左室功能。Tei指数更能早期反映心脏的整体功能。OBJECTIVE To observe the efficacy of astragalus injection on cardiac hypertrophy by Doppler echocarcllograpny, and to evalurate left ventricular function by using the Dopplerderived myocardial performance index（MPI） in elderly patients with essential hypertension. METHODS Sixty patients were randomized into treatment group and control group. Two groups were treated by {elodipine sustaind-release tablets, 5 mg qd. Treatment group was added with astragalus injection 30 mL qd, iv gtt, for 6 weeks. To calculate Tel index based on sum of isovolumetric relaxation rime and isovolumetric contraction time and its ratio with ejection time. RESULTS The left ventricle mass index of patients with left ventricular hypertrophy（LVH） was lower after treatment with Astragalus root injection： it was （161 ±36）g·m^-2 before treatment, which was reduced to （137 ± 21 ）g·m^-2 （P〈0. 05） after treatment. The ejection fractions of two groups are both in normal range. Mitral early diastolic filling E velocities increased remarkably after treatment. The indexes were （586.5 ± 173.9）cm·s^-2 and （742.2 ± 199. 8）cm·s^-2 （649. 1 ± 199. 4）cm·s^-2 and （79B. 3 ± 227.3）cm·s^-2 respectively in treatment and control group （P〈0.01）. In treatment group the isometric diastolic time and ejection time were improved after treatment, they were （118. 6 ±23.8）ms and （93.3 ± 23.4） ms; （255.9 ± 36. 2）ms and （292. 3 ±35.7）ms respectively （P〈0. 01 ）. Tei index was reduced to （0. 43 ± 0. 09） ,compared with （0. 58 ±0.11） after treatment （P〈0.0l）. CONCLUSION Astragalus injection has reversible role to left ventrieular hypertrophy, and can improve adaptability of cardiac muscle. It can effectively improve the left ventricle function of aged patients with hypertension. Tel index can reflect the whole function of heart earlierly.

关 键 词：黄芪注射液 老年高血压 左室心功能 

分 类 号：R285.6[医药卫生—中药学]