参麦注射液联合无创双水平气道正压通气治疗老年慢性肺源性心脏病合并心力衰竭的临床疗效及对血清D-二聚体和N-末端脑利钠肽前体水平的影响  

Clinical Effect of Shenmai Injection Combined with Non-invasive Bi-level Positive Airway Pressure Ventilation on Elderly Chronic Pulmonary Heart Disease Patients Complicated with Heart Failure and Its Impact on Serum Levels of D-dimer and N-terminal Pro-br

作　　者：王永[1] 刘勇[1] 朱宝山[1] 范远威[1] 

机构地区：[1]江苏省新沂市铁路医院,221400

出　　处：《实用心脑肺血管病杂志》2015年第10期112-114,117,共4页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：目的探讨参麦注射液联合无创双水平气道正压通气(Bi PAP)治疗老年慢性肺源性心脏病(CPHD)合并心力衰竭的临床疗效,并观察其对血清D-二聚体及N-末端脑利钠肽前体(NT-pro BNP)水平的影响。方法选取2011—2014年新沂市铁路医院收治的老年CPHD合并心力衰竭患者96例,按就诊顺序单双号分为治疗组和对照组,每组48例。两组患者均给予常规治疗,对照组患者在常规治疗基础上采用复方丹参注射液治疗,治疗组患者在常规治疗基础上采用参麦注射液联合Bi PAP治疗;两组患者均治疗10 d。比较两组患者的临床疗效,治疗前后血清D-二聚体、NT-pro BNP水平及治疗后纽约心脏病协会(NYHA)心功能分级,并观察两组患者不良反应发生情况。结果治疗组患者临床疗效优于对照组(u=2.370,P<0.05)。治疗前两组患者血清D-二聚体、NT-pro BNP水平比较,差异无统计学意义(P>0.05);治疗后治疗组患者血清D-二聚体、NT-pro BNP水平均低于对照组(P<0.01)。治疗组患者治疗后NYHA心功能分级优于对照组(u=2.274,P=0.023)。两组患者均未出现严重的不良反应。结论参麦注射液联合Bi PAP治疗CPHD合并心力衰竭的临床疗效确切,能有效改善患者心功能,降低血清D-二聚体及NT-pro BNP水平,且无严重不良反应。Objective To investigate the clinical effect of shenmai injection combined with non-invasive bi-level positive airway pressure（Bi PAP）ventilation on elderly chronic pulmonary heart disease（CPHD）patients complicated with heart failure and its impact on serum levels of D-dimer and N-terminal pro-brain natriuretic peptide（NT-pro BNP）.Methods A total of 96 elderly CPHD patients complicated with heart failure were selected in Railway Hospital of Xinyi from^2011 to 2014,and they were divided into control group and treatment group according to odd or even number of visiting sequence,each of 48 cases.Based on the conventional treatment,patients of control group were given extra compound danshen injection,while patients of treatment group were given extra shenmai injection combined with Bi PAP ventilation,both groups treated for 10 days.Clinical effect,serum levels of D-dimer and NT-pro BNP before and after treatment,NYHA cardiac functional grading after treatment were compared between the two groups,and incidence of adverse reactions was observed.Results The clinical effect of treatment group was statistically significantly better than that of control group（u = 2.370,P〈0.05）.No statistically significant differences of serum level of D-dimer or NT-pro BNP was found between the two groups before treatment（P〉0.05）,while serum levels of D-dimer and NT-pro BNP of treatment group were statistically significantly lower than those of control group after treatment（P〈0.01）.NYHA cardiac functional grading after treatment of treatment group was statistically significantly better than that of control group（u = 2.274,P = 0.023）.No one of the two groups occurred any serious adverse reactions.Conclusion Shenmai injection combined with Bi PAP ventilation has certain clinical effect in treating elderly CPHD patients complicated with heart failure,can effectively improve the cardiac function,reduce the serum levels of D-dimer and NT-pro BNP without serious adverse reactions.

关 键 词：肺源性心脏病 心力衰竭 老年人 参麦注射液 连续气道正压通气 D-二聚体 N-末端脑利钠肽前体 

分 类 号：R541.5[医药卫生—心血管疾病]