丹参片对慢性心力衰竭患者的疗效及预后影响  

Efficacy of Danshen and its impact on prognosis in treatment of patients with chronic heart failure

作　　者：周清芬[1] 朱菲白[1] 干倩[1] 戴丽莹[1] 刘晔宏[1] 柴熙晨[1] 任艳[1] 虞莹君[1] 张凤如[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院老年病科,上海200025

出　　处：《内科理论与实践》2011年第6期428-430,共3页Journal of Internal Medicine Concepts & Practice

摘　　要：目的:观察在常规治疗的基础上加用丹参对慢性心力衰竭(HF)的治疗作用。方法:入选250例具有心功能不全的临床表现、左心室射血分数(LVEF)≤45%、美国纽约心脏病协会(NYHA)心功能分级Ⅱ～Ⅲ级、病情相对稳定的门诊及住院HF患者,分为丹参组和对照组各125例,对照组接受常规抗HF治疗,丹参组在常规治疗基础上加用丹参片(3片/次,3次/d)。平均随访1年,观察治疗前、后超声心动图指标、氨基末端B型钠尿肽(NT-ProBNP)、高敏C反应蛋白(hs-CRP)、肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)、IL-10变化及主要心血管事件(MCE)(包括死亡、心脏移植及难治性HF再住院)。结果:与对照组相比,丹参组的各项指标在常规治疗基础上有进一步改善,LVEF增加(P<0.05),左心室舒张末期和收缩末期内径缩小(均P<0.05),NT-ProBNP、hs-CRP、TNF-α和IL-6水平均降低(均P<0.05),IL-10升高(P<0.05)。丹参组的MCE发生率低(P<0.05)。结论:丹参能减轻心脏负荷,降低炎症因子水平,从而具有保护心脏的作用。在常规治疗基础上,加用中药丹参片有助于抗HF治疗并改善慢性HF患者的预后。Objective To study the efficacy of adding Danshen on the basis of conventional therapy for the treatment of patients with chronic heart failure （CHF）. Methods A total of 250 CHF patients with clinical manifestations of cardiac insufficiency, left ventrieular ejection fraction （LVEF）≤45% and New York Heat Association （NYHA） function class Ⅱ -Ⅲ were enrolled. Patients were divided into two groups： one hundred and twenty-five patients in Danshen group and 125 patients in control group. Patients in Danshen group were given additionally the Danshen tablet （3 tablets tid.） on the basis of conventional therapy. Patients were followed for an average of 1 year. Echocardiographic parameters, levels of pro-brain natriuretic peptide （NT-ProBNP）, high sensitive C reactive protein（hs-CRP）, tumor necrosis factor-α （TNF-α）, interleukin （IL）- 6, and IL-10 were measured before and after treatment. Major cardiac events （MCE） including death, heart transplantation, and refractory heart failure were recorded. Results Test items in Danshen group were further improved when compared with the control group. Treatment with additional Danshen increased LVEF （P〈0.05）, decreased left ventricular end-diastolic dimension （LVEDD） （P〈0.05）and left ventricular end-systolic dimension （LVESD） （P〈O.05）, decreased NT-ProBNP （P〈0.05） and hs-CRP （P〈0.05）, decreased TNF-a （P〈0.05）and IL-6 （P〈0.05）, and increased IL-10 （P〈0.05）; MCE incidence rate was decreased （P〈0.05）. Conclusions Danshen can reduce cardiac load, invigorate circulation and alleviate blood stasis, and reduce the level of inflammatory factor, thereby has the effect of protecting heart. Thus, additional use of Danshen on the basis of conventional therapy is helpful for the treatment of CHF and can improve the prognosis of patients with CHF.

关 键 词：慢性心力衰竭 丹参片 疗效 预后 

分 类 号：R259[医药卫生—中西医结合]