芪苈强心胶囊联合靶向药物治疗急性肺栓塞后所致慢性血栓栓塞性肺动脉高压疗效及对血管内皮功能及心肺功能的影响  

Effect of Qili Qiangxin Capsule combined with targeted drugs on chronic thromboembolic pulmonary hypertension caused by acute pulmonary embolism and its influence on endothelial function and cardiopulmonary function

作　　者：宋国斌[1] 张丽娟[1] 周凤鱼 SONG Guobin;ZHANG Lijuan;ZHOU Fengyu(The First Hospital of Shijiazhuang City,Shijiazhuang 050000,Hebei,China;Shijiazhuang Great Wall Hospital of Integrated Traditional Chinese and Western Medicine,Shijiazhuang 050000,Hebei,China)

机构地区：[1]河北省石家庄市第一医院,河北石家庄050000 [2]石家庄长城中西医结合医院,河北石家庄050000

出　　处：《现代中西医结合杂志》2019年第28期3119-3123,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的观察芪苈强心胶囊联合靶向药物治疗急性肺栓塞后所致慢性血栓栓塞性肺动脉高压(CTEPH)疗效及对血管内皮功能及心肺功能的影响。方法将60例急性肺栓塞后所致CTEPH患者按照随机数字表分为观察组30例和对照组30例,对照组给予靶向药物治疗,观察组给予靶向药物联合芪苈强心胶囊治疗,2组疗程均为12周。记录2组临床疗效,观察2组治疗前后临床症状评分、6 min步行距离、呼吸困难程度、超声心动图检查指标、血管内皮功能指标、心肺运动试验参数的变化。结果观察组临床疗效显著优于对照组(P<0.05)。2组治疗后临床症状评分、mMRC呼吸困难量表评分、肺动脉收缩压(PASP)、右室舒张末期内径(RVEDD)、右心室Tei指数及血浆内皮素-1(ET-1)、血管内皮生长因子(VEGF)水平均较治疗前明显降低(P均<0.05),6 min步行距离、三尖瓣环平面收缩期位移(TAPSE)及血浆一氧化氮(NO)水平均较治疗前明显提高(P均<0.05),观察组治疗后以上指标均优于对照组(P均<0.05)。2组治疗后心肺运动试验参数中峰值功率、峰值氧耗量、无氧阈、峰值氧脉搏、峰值分钟通气量、呼气末二氧化碳分压、峰值氧饱和度较治疗前明显升高(P均<0.05),观察组治疗后以上指标均明显高于对照组(P均<0.05)。结论芪苈强心胶囊联合靶向药物治疗急性肺栓塞后所致CTEPH疗效确定,不仅能降低肺动脉压力,改善临床症状,还能保护血管内皮细胞功能,从而提高心肺功能和运动耐量。Objective It is to observe the curative effect of Qili Qiangxin Capsule combined with targeted drugs on chronic thromboembolic pulmonary hypertension(CTEPH)induced by acute pulmonary embolism and its effects on vascular endothelial function and cardiopulmonary function.Methods Sixty patients with CTEPH after acute pulmonary embolism were randomly divided into observation group(n=30)and control group(n=30).The control group was given targeted drug therapy.The observation group was given targeted drug combined with Qili Qiangxin Capsule.Both groups were treated for 12 weeks.The clinical efficacy of the two groups was evaluated.The changes of clinical symptom scores,6 min walking distance,dyspnea degree,echocardiographic indexes,vascular endothelial function indexes and cardiopulmonary exercise test parameters were observed before and after treatment.Results The clinical efficacy of the observation group was significantly better than that of the control group(P<0.05).The post-treatment clinical symptom scores,NYHA cardiac function classification,mMRC dyspnea scale scores,pulmonary systolic pressure(PASP),right ventricular end-diastolic diameter(RVEDD),right ventricular Tei index,and levels of plasma endothelin-1(ET-1)and vascular endothelial growth factor(VEGF)were significantly lower while the 6-minute walking distance,tricuspid annular plane systolic excursion(TAPSE)and level of plasma nitric oxide(NO)were significantly high er than those before treatment in the two groups(P<0.05),the improvements of the above indexes were better in the observation group than those in the control group(P<0.05).The cardiopulmonary exercise test parameters like peak power,peak oxygen consumption,anaerobic threshold,peak oxygen pulse,peak minute ventilation,end-tidal carbon dioxide partial pressure,and peak oxygen saturation were significantly higher after treatment than those before treatment in the two groups(P<0.05),the above indicators were significantly higher in the observation group than those in the control group(P<0.05).Conc

关 键 词：芪苈强心胶囊 靶向治疗 急性肺栓塞 慢性血栓栓塞性肺动脉高压 血管内皮功能 心肺功能 

分 类 号：R543.2[医药卫生—心血管疾病]