参芪扶正注射液治疗老年急性心肌梗死后心力衰竭的疗效观察  

Clinical Observation on Shenqi Fuzheng Injection in the Treatment of Aged Patients with Heart Failure after Acute Myocardial Infraction

作　　者：肖冬[1] 张会珍[2] 左希宏[2] 王辉[1] 张艳玲[2] 

机构地区：[1]济南医院,济南250000 [2]济南市第一人民医院

出　　处：《中西医结合心脑血管病杂志》2016年第10期1061-1063,共3页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨参芪扶正注射液治疗老年急性心肌梗死心力衰竭的疗效。方法将发病3d^5d的急性透壁性心肌梗死合并心力衰竭老年病人56例(所有病人均未进行溶栓和介入治疗),随机分为参芪扶正组(28例)和常规治疗组(28例)。常规治疗组给予抗凝、双重抗血小板聚集、他汀类药物、扩冠、改善心脏功能等常规治疗,参芪扶正组在常规治疗的基础上加用参芪扶正注射液250mL静脉输注,10d为1个疗程。分别观察两组治疗前后NYHA心功能分级改善情况,测定两组血清肿瘤坏死因子-α(TNF-α)、白介素-6(IL-6)、C反应蛋白(CRP)、N末端脑钠肽前体(NT-proBNP)水平,心脏超声检测左室射血分数(LVEF)。结果参芪扶正组NYHA心功能分级临床有效率92.9%,明显高于常规治疗组67.8%(P<0.05),参芪扶正组治疗后血清TNF-α、IL-6、CRP、NT-proBNP水平分别为(90.5±23.9)pg/mL、(19.3±5.3)ng/L、(10.5±4.0)μmol/L、(815.7±377.0)pg/mL,常规治疗组分别为(144.3±48.8)pg/mL、(27.0±5.8)ng/L、(17.67±5.9)μmol/L、(1 395.3±525.7)pg/mL;参芪扶正组治疗后血清TNF-α、IL-6、CRP、NT-proBNP水平明显低于常规治疗组(P<0.05),参芪扶正组治疗后LVEF(56.7±5.4)%。高于常规治疗组(52.0±4.8)%,但无统计学意义(P>0.05)。结论参芪扶正注射液可以明显改善心肌梗死后心力衰竭病人的心脏功能,其机制之一可能与抑制炎症反应有关。Objective To investigate the effect of Shenqi Fuzheng injection（SFI）in the treatment of aged patients with heart failure （HF）after acute myocardial infraction（AMI）.Methods Fifty six patients with AMI for 3 days to 5 days accompanied with HF （with-out fibrinolytic therapy and PCI）were randomly divided into two groups：control group （n=28）treated with routine treatment,and treatment group （n=28）treated with routine treatment plus SFI for 10 days.The NHYA class index,left ventricular ejection fraction （LVEF）,the levels of serum N terminal pro brain natriuretic peptide （NT proBNP）,tumor necrosis factor α（TNF α）,IL 6,C reac-tive protein （CRP）were measured before and after treatment.Results The total effective ratios of the improvement on NYHA class was 92.9% in treatment group,which was significantly higher than that in control group （67.8%,P〈0.05）.The levels of serum TNFα,IL 6,CRP,NT proBNP was （90.5± 23.9）pg/mL,（19.3± 5.3）ng/L,（10.5± 4.0）μmol/L,（815.7± 377.0）pg/mL in treatment group after treatment,and （144.3± 48.8）pg/m L,（27.0± 5.8）ng/L,（17.67± 5.9）μmol/L,（1 395.3± 525.7）pg/mL in control group respective-ly,which in the treatment group after treatment were lower than in control group（P〈0.05）.Conclusion SFI can improve the cardiac function by inhibiting inflammatory response in patients with HF after AMI.

关 键 词：急性心肌梗死 心力衰竭 参芪扶正注射液 炎性因子 老年 心悸 

分 类 号：R259[医药卫生—中西医结合]