丹参酮ⅡA磺酸钠联合尼可地尔对老年急性左心衰竭患者心室重构的影响  

Effect of tanshinone ⅡA sodium sulfonate combined with nicorandil on ventricular remodeling in senile patients with acute left ventricular failure

作　　者：曾健[1] 吴镜[1] 蔡琳[1] 符金娟 ZENG Jian;WU Jing;CAI Lin(Chengdu Third People's Hospital,Department of Cardiology,Chengdu 610031,Sichuan,China)

机构地区：[1]成都市第三人民医院心血管内科,四川成都610031

出　　处：《中国老年学杂志》2020年第24期5157-5160,共4页Chinese Journal of Gerontology

基　　金：国家自然科学基金资助项目(81800239)。

摘　　要：目的探讨丹参酮ⅡA磺酸钠联合尼可地尔对老年急性左心衰竭患者心室重构的影响。方法选取92例老年急性左心衰竭患者,依据盲抽法分为两组,各46例。两组均应用常规抗心力衰竭方案治疗,鉴于此,对照组予以尼可地尔口服治疗,观察组于对照组治疗基础上加用丹参酮ⅡA磺酸钠静脉滴注治疗,连续应用4 w后,比较两组临床疗效、脑利钠肽(BNP)水平、心功能指标〔左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、左心室收缩末期内径(LVESD)、每搏输出量(SV)〕、血流动力学指标〔中心静脉压(CVP)、平均肺动脉压(MPAP)、肺循环阻力(PVR)、体循环阻力(SVR)〕及不良反应发生率。结果观察组临床总有效率显著高于对照组(P<0.05);与治疗前相比,两组治疗4 w后BNP水平降低,且观察组水平明显低于对照组(P<0.05);与治疗前相比,两组治疗4 w后LVEDD、LVESD水平均降低,LVEF、SV水平较升高,且观察组变化较对照组更显著(P<0.05);与治疗前相比,两组治疗4 w后CVP、MPAP、PVR、SVR水平均降低,且观察组明显低于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。结论老年急性左心衰竭患者采用丹参酮ⅡA磺酸钠联合尼可地尔治疗疗效显著,可有效降低BNP水平,调节血液流动力学,改善患者心功能,抑制心室重构,且安全性高,副作用少。Objective To investigate the effect of tanshinone ⅡA sodium sulfonate combined with nicorandil on ventricular remodeling in senile patients with acute left ventricular failure,and to provide reference for clinical medication.Methods 92 senile patients with acute left ventricular failure who admitted in the hospital from September 2018 to September 2019 were divided into two groups according to blind selection method,with 46 cases in each group.Two groups were treated with routine anti-heart failure regimen,and on this basis,control group orally took nicorandil,and observation group was treated with intravenous drip of tanshinone ⅡA sodium sulfonate based on control group.After treatment for 4 weeks,the clinical efficacy,brain natriuretic peptide(BNP),cardiac function indexes〔left ventricular end-diastolic dimension(LVEDD),left ventricular ejection fraction(LVEF),left ventricular end-systolic dimension(LVESD),stroke volume(SV)〕,hemodynamic indexes〔central venous pressure(CVP),mean pulmonary arterial pressure(MPAP),pulmonary vascular resistance(PVR),systemic vascular resistance(SVR)〕and the incidence of adverse reactions were compared between two groups.Results The total clinical effective rate of observation group was significantly higher than that of control group(P<0.05).Compared with before treatment,the levels of BNP decreased in two groups after treatment for 4 weeks,and the level of observation group was lower than that of control group(P<0.05);The levels of LVEDD and LVESD in two groups decreased after treatment for 4 weeks,the levels of LVEF and SV increased,and observation group changed more significantly than control group(P<0.05);The levels of CVP,MPAP,PVR and SVR in two groups decreased after treatment for 4 weeks,the levels of observation group were lower than those of control group(P<0.05).The incidence of adverse reactions in observation group was lower than that in control group,but the difference was not statistically significant(P>0.05).Conclusions Tanshinone ⅡA sodium sulfonate com

关 键 词：急性左心衰竭 丹参酮ⅡA磺酸钠 尼可地尔 心室重构 脑利钠肽 心功能指标 血流动力学 

分 类 号：R541.6[医药卫生—心血管疾病]