不同剂量麝香保心丸对慢性心衰冠心病患者心室重塑的影响  

Effect of Different Doses of Heart-protecting Musk Pill on Ventricular Remodeling in Patients with Coronary Heart Disease and Chronic Heart Failure

作　　者：刘左玲 刘衍宇[1] 凌云[1] 陈晓[1] 许锦荣[1] 方凌燕[1] 

机构地区：[1]广东医学院第二附属医院,广东湛江524003

出　　处：《中国中医急症》2016年第6期1117-1120,共4页Journal of Emergency in Traditional Chinese Medicine

基　　金：广东省湛江市非资助科技攻关专题(2015B101)

摘　　要：目的观察不同剂量的麝香保心丸干预慢性心衰冠心病患者心室重塑的效果。方法 90例患者按随机数字表法分为对照组、麝香保心丸小剂量组、麝香保心丸大剂量组3组各30例。对照组给予指南规定的抗心衰治疗;麝香保心丸小剂量组在对照组基础上予以麝香保心丸每次2片,每日3次;麝香保心丸大剂量组在对照组基础上予以麝香保心丸每次4片,每日3次。疗程均为6个月。治疗后比较3组氨基末端脑钠肽前体(NT-pro BNP)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)、基质金属蛋白酶(MMP)-2、基质金属蛋白酶组织抑制剂(TIMP)-2水平的差异;比较3组左室射血分数(LVEF)、左室收缩末期容积(LVESV)、左室舒张末期容积(LVEDV)和室壁运动积分指数(WMSI)的差异。结果麝香保心丸大剂量组的NT-pro BNP、AngⅡ、ALD、MMP2水平与麝香保心丸小剂量组和对照组比较均降低(均P<0.05),而TIMP2水平则升高(均P<0.05)。麝香保心丸小剂量组的NT-proBNP、AngⅡ、ALD、MMP2及TIMP2水平与对照组比较差别均不大(均P>0.05)。与麝香保心丸小剂量组与对照组比较,麝香保心丸大剂量组的LVEF升高,LVESV、LVEDV、WMSI水平降低(均P<0.05)。麝香保心丸小剂量组与对照组的LVEF、LVESV、LVEDV及WMSI水平差别均不大(均P>0.05)。结论大剂量麝香保心丸能显著改善慢性心衰冠心病患者的心室重塑程度,但小剂量则效果不明显。Objective： To analyze the effect of different doses of heart-protecting musk pill（HMP） on ventricular remodeling in patients with coronary heart disease（CHD） and chronic heart failure（CHF）. Methods： 90 patients were randomly divided into three groups,30 cases in each： the control group（receiving normal anti-CHF therapy according to guidance）,small-dose group（receiving 2 tablets HMP,three times,based on the control group therapy） and large-dose group（receiving 4 tablets HMP,three times,based on the control group therapy）.The course of therapy was 6 months. After treatment,the indexes of NT-pro BNP,AngⅡ,ALD,MMP2 and TIMP2 were detected and compared among three groups. The levels of LVEF,LVESV,LVEDV and WMSI were also detected and compared among three groups. Results： Compared with the control group and small-dose group,the indexes of NT-proBNP,Ang Ⅱ,ALD and MMP2 in large-dose group were lower,and the index of TIMP2 was higher（P〈0.05）. But the above indexes were no significant difference between the control group and small-dose group（P〈0.05）. Compared with the control group and small-dose group,the index of LVEF in large-dose group was higher,and the indexes of LVESV,LVEDV and WMSI in large-dose group were lower（P〈0.05）. But the above indexes were no significant difference between the control group and small-dose group（P〈0.05）. Conclusions： The large dose of HMP can obviously improve the ventricular remodeling in patients with CHD and CHF,but small dose of HMP hasn′t this effect.

关 键 词：慢性心衰 冠心病 麝香保心丸 心室重塑 

分 类 号：R541.61[医药卫生—心血管疾病]