复方丹参滴丸联合比索洛尔治疗冠心病合并慢性心力衰竭的效果  

Effect of Compound Danshen Dripping Pills Combined with Bisoprolol on Coronary Heart Disease Complicated by Chronic Cardiac Failure

作　　者：郑颖[1] 王柳[1] 林德洪[1] 陈漠水[1] ZHENG Ying;WANG Liu;LIN De-hong;CHEN Mo-shui(Department of Cardiology,the Affiliated Haikou Hospital of Xiangya Medical College,Central South University,Haikou 570208,China)

机构地区：[1]中南大学湘雅医学院附属海口医院心内科

出　　处：《实用临床医学（江西）》2019年第5期1-5,共5页Practical Clinical Medicine

基　　金：海南省自然科学基金面上项目(SQ2017MSXM0524)

摘　　要：目的探讨复方丹参滴丸联合比索洛尔治疗冠心病合并慢性心力衰竭的临床疗效。方法 选取2015年9月至2017年10月就诊的冠心病合并慢性心力衰竭患者,共147例。按治疗方法的不同将其分为治疗组(n=75)和对照组(n=72)。对照组予常规抗心衰治疗,治疗组在此基础上加用复方丹参滴丸和比索洛尔,2组均持续治疗6个月。比较2组患者治疗前后血液流变学指标(红细胞压积、血浆黏度、全血黏度高切及全血黏度低切等),心功能指标[左室射血分数(LVEF)、左心室收缩末期容积(LVESV)及左室舒张末期容积(LVEDV)],血清学指标[血清钠肽N端脑钠肽前体(Pro-BNP)、高敏C反应蛋白(hs-CRP)和血管内皮生长因子(VEGF)],并比较2组疗效、不良反应发生情况。结果 治疗后:2组较治疗前血液流变学指标明显下降(P<0.05),且治疗组下降幅度更为明显(P<0.05);2组较治疗前LVEF明显提高(P<0.05),LVESV和LVEDV明显下降(P<0.05),血清hs-CRP、Pro-BNP水平明显下降(P<0.01),VEGF水平明显提高(P<0.01),且治疗组心功能、血清学指标改善情况明显好于对照组(P<0.05,P<0.01)。治疗组总有效率高于对照组(89.3%比76.4%,P<0.05)。2组不良反应发生率比较差异无统计学意义(P>0.05)。结论 复方丹参滴丸联合比索洛尔治疗冠心病合并慢性心力衰竭可有效改善患者心肌缺血情况,降低血液黏度,增强心肌收缩力,明显改善心功能,提高临床疗效,且不良反应少、安全性高。Objective To explore the clinical effect of compound Danshen dripping pills(CDDP)combined with bisoprolol on coronary heart disease complicated by chronic cardiac failure.Methods A total of 147 patients with coronary heart disease and chronic cardiac failure who were admitted to our hospital from September 2015 to October 2017 were given traditional anti-heart failure therapy alone(control group,n=72)or in combination with CDDP and bisoprolol(treatment group,n=75)for 6 months.Hemodynamic indexes(hematocrit,plasma viscosity,high-shear blood viscosity and low-shear rate blood viscosity),cardiac parameters(left ventricular ejection fraction(LVEF),left ventricular end-systolic volume(LVESV)and left ventricular end-diastolic volume(LVEDV))and serological indicators(pro-brain natriuretic peptide(Pro-BNP),high sensitivity C-reactive protein(hs-CRP)and vascular endothelial growth factor(VEGF))were measured before and after treatment.Curative effect and adverse reactions were compared between the two groups.Results After treatment,hemodynamic indexes decreased in both groups,and the decrease in treatment group was more obvious than that in control group(P<0.05).Furthermore,the LVEF and serum VEGF levels increased but the LVESV,LVEDV and serum hs-CRP and Pro-BNP levels decreased in both groups(P<0.05 or P<0.01).Compared with control group,cardiac and serological indicators were significantly improved in treatment group(P<0.05 or P<0.01).Moreover,the total effective rate in treatment group was higher than that in control group(89.3%vs 76.4%,P<0.05).No significant difference in the incidence of adverse reactions was found between the two groups(P>0.05).Conclusion The combination of CDDP and bisoprolol can effectively and safely improve cardiac function,relieve myocardial ischemia,enhance myocardial contractility,reduce blood viscosity and decrease adverse reactions in patients with coronary heart disease and chronic cardiac failure.

关 键 词：冠心病 心力衰竭 慢性 复方丹参滴丸 比索洛尔 疗效 

分 类 号：R541.4[医药卫生—心血管疾病] R541.6[医药卫生—内科学]