四逆加黄连方联合无创正压通气对急诊心力衰竭血清NT-proBNP、Galectin-3、CK-MB及氧动力学指标的影响  

Influence of decoction for treating yang exhaustion plus coptis root combined with noninvasive positive pressure ventilation on serum NT proBNP Galectin-3,ck-MB,and oxygen kinetic indexes

作　　者：吕晓霞 李玉明[2] 宋兰英[2] 孙俊霞 王亚莉[2] 郭瑞娟 LYU Xiaoxia;LI Yum-ing;SONG Lanying;SUN Junxia;WANG Yali;GUO Ruijuan(Department of Cardiology,Mingren Hospital,Handan Hebei 056000,China)

机构地区：[1]邯郸明仁医院急诊科,河北邯郸056000 [2]邯郸明仁医院心内科,河北邯郸056000

出　　处：《中国急救复苏与灾害医学杂志》2022年第1期72-75,88,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：河北省中医药管理局科研计划项目(编号:2020592)。

摘　　要：目的观察四逆加黄连方联合无创正压通气用于急性心力衰竭患者疗效的影响,及其对患者Galectin-3、NT-proBNP、CK-MB及氧动力学指标的影响。方法选取2017年1月—2020年5月于邯郸明仁医院治疗的急性心力衰竭患者162例,按照随机数字表法分为对照组和观察组,每组81例。对照组患者给予无创呼吸机辅助通气,观察组在对照组的基础上给予四逆加黄连方即四逆汤+黄连方。8周为1个疗程,进行1个疗程的治疗。比较两组患者临床指标、氧动力学指标[氧分压(PO2)、二氧化碳分压(PCO2)、氧耗量(VO2)、氧输送(DO2)]、短期预后、Galectin-3、NT-proBNP、CK-MB及肌钙蛋白水平。结果经过1个疗程的治疗,观察组的临床总有效率为88.89%,显著高于对照组的70.37%(χ^(2)=8.560,P=0.003)。治疗前,两组患者氧动力学指标PaCO2、VO2、PaO2、DO2、Galectin-3、NT-proBNP、肌钙蛋白及CK-MB水平无差异(P>0.05)。治疗后,观察组的氧动力学指标PaCO2、VO2、PaO2、DO2高于对照组(t=5.310,P=0.000;t=6.410,P=0.000;t=10.151,P=0.000;t=4.977,P=0.000)。观察组的Galectin-3、NT-proBNP、肌钙蛋白及CK-MB水平低于对照组(t=17.563,P=0.000;t=10.972,P=0.000;t=5.922,P=0.000;t=24.695,P=0.000)。观察组的插管率及病死率均低于对照组(χ^(2)=4.100,P=0.043;χ^(2)=5.760,P=0.016)。结论四逆加黄方联合无创正压通气用于急性心力衰竭具有良好的临床疗效,可以改善患者心肌损伤,提高患者氧动力学,改善血管内皮功能,且短期预后好,病死率低。Objective To observe the effect of sini plus Huang prescription combined with non-invasive positive pres⁃sure ventilation in patients with acute heart failure,and its effect on patients with Galectin-3,NT-probNP,CK-MB and oxygen dynamics indicators.Methods A total of 162 patients with acute heart failure who were treated in our hospital from January 2017 to May 2010 were selected and divided into control group and observation group accord⁃ing to the random number table method,with 81 patients in each group.Patients in the control group were given non invasive ventilator assisted ventilation,and patients in the observation group were given Sini plus Coptis decoction(sini Decoction+Coptis decoction)on the basis of the control group.8 weeks for 1 course of treatment,1 course of treatment.Clinical indicators,oxygen dynamic indicators[oxygen partial pressure(PO2),carbon dioxide partial pres⁃sure(PCO2),oxygen consumption(VO2),oxygen transport(DO2)],short-term prognosis,Galectin-3,NT-probNP,CK MB and troponin levels were compared between the two groups.Results After one course of treatment,the clinical effective rate of the observation group was 88.89%,significantly higher than that of the control group(χ^(2)=8.560,P=0.003).Before treatment,there was no difference in oxygen dynamics between the two groups in PaCO2,VO2,PaO2,DO2,Galectin-3,Nt-probNP,troponin and CK-MB(P>0.05).After treatment,the oxygen dynamics indicators of Pa⁃CO2,VO2,PaO2 and DO2 in the observation group were higher than those in the control group(t=5.310,P=0.000;t=6.410,P=0.000;t=10.151,P=0.000;t=4.977,P=0.000).The levels of Galectin-3,Nt-probNP,troponin and CK-MB in the observation group were lower than those in the control group(t=17.563,P=0.000;t=10.972,P=0.000;t=5.922,P=0.000;t=24.695,P=0.000).The intubation rate and death rate in the observation group were lower than those in the control group(χ^(2)=4.100,P=0.043;χ^(2)=5.760,P=0.016).Conclusion Sini plus Huang formula combined with non-in⁃vasive positive pressure ventilation for acute

关 键 词：四逆加黄连方 无创正压通气 急诊心力衰竭 NT-proBNP GALECTIN-3 CK-MB 氧动力学 

分 类 号：R541.61[医药卫生—心血管疾病]