参附注射液对顽固性心力衰竭合并低血压患者心肾功能的影响  

Influence of Shenfu Injection on heart and kidney function of patients with refractory heart failure combined hypotension

作　　者：袁方[1] 刘华[1] 戴锦杰[1] 戴丽莹[1] 王雯霞[1] 

机构地区：[1]上海市胸科医院心内科,上海200030

出　　处：《中华中医药杂志》2014年第10期3295-3297,共3页China Journal of Traditional Chinese Medicine and Pharmacy

基　　金：上海市卫生局局级科研项目(No.20114324)~~

摘　　要：目的:探讨参附注射液对顽固性心力衰竭合并低血压患者心肾功能的影响。方法:60例顽固性心力衰竭合并低血压患者纳入研究,随机分为治疗组和对照组,各30例。治疗组以参附注射液大剂量(80mL/d)静脉滴注,每天1次,共治疗7d;对照组以多巴胺200mg+多巴酚丁胺200mg(5-10μg·kg-1·min-1)静脉滴注,每天1次,共治疗7d。观察两组治疗前后尿量(UV)、收缩压(SBP)、心率(HR)、肾功能及血管紧张素(RAAS)系统、血浆脑钠肽水平(BNP)及左室射血分数(LVEF)的改变。结果:两组在治疗后24、48h的SBP与同组治疗前差异有统计学意义(P<0.05),两组之间无显著性差异。治疗组在治疗后24、48h的HR较治疗前明显减慢(P<0.05),对照组在治疗24、48h后HR较治疗前明显加快(P<0.05),两组HR同期比较有显著性差异,治疗组较对照组心率明显减慢(P<0.05)。两组在治疗后48h的血清肌酐(SCr)均较同组治疗前显著下降(P<0.05);表皮生长因子(eGFR)在治疗后48h均较同组治疗前显著升高(P<0.05),eGFR在两组同期比较显著上升(P<0.05)。治疗组治疗24、48h后较用药前血浆肾素活性、血管紧张素Ⅱ及醛固酮水平明显下降(P<0.05);对照组治疗24、48h后较用药前血浆肾素活性、血管紧张素Ⅱ及醛固酮水平明显上升(P<0.05)。治疗组在治疗后7d的BNP水平显著低于对照组(P<0.01);LVEF显著高于对照组(P<0.01)。结论:对顽固性心力衰竭合并低血压患者应用大剂量参附注射液治疗较多巴胺、多巴酚丁胺能更有效地改善患者的心肾功能。Objective： To investigate the influence of Shenfu Injection（SFI） on heart and kidney function of patients with refractory heart failure combined hypotension. Methods： Sixty patients with refractory heart failure combined with hypotension were included in this study, and were randomly divided into two groups： experimental group and control group, with 30 patients in each group. Patients in the experimental group were given SFI with dose of 80mL/d for 7 days, and patients in the control group were intravenously given Dopamine 200mg/d and Dobutamine 200mg/d（5-10μg·kg-1·min-1） for 7 days. Urina volume（UV）, systolic blood pressure（SBP）, heart rate（HR）, renal function, renin-angiotensin-aldosterone system（RAAS）, serum B-type natriuretic peptide（BNP） and left ventricular ejection fraction（LVEF） were measured before and after treatment. Results： After treatment for 24 hours and 48 hours, SBP in two groups was significantly higher than that before treatment（P〈0.05）, and the difference between the two groups was not significant. After treatment for 24 hours and 48 hours, HR in two groups was significantly lower than that before treatment（P〈0.05）, and HR in the experimental group was significantly lower than that in the control group（P〈0.05）. After treatment for 48 hours, SCr and eGFR were both significantly lower than that before treatment（P〈0.05）, and the difference between the two groups was significant（P〈0.05）. In the experimental group, plasma renin activity, angiotensin Ⅱ and aldosterone declined rapidly and significantly 24 h and 48 h after treatment（P〈0.05）, while in the control group, these three factors remained stable. The level of BNP in patients of the experimental group was lower than that in the the controlgroup 7 days after treatment（P〈0.01）, while the LVEF level of the experimental group was higher than that of the control group（P〈0.01）. Conclusion： Compared with Dopamine and Dobutamine therapies, high dose of SFI

关 键 词：参附注射液 顽固性心力衰竭 低血压 心功能 肾功能 血管紧张素系统 

分 类 号：R259[医药卫生—中西医结合]