参麦注射液联合曲美他嗪治疗老年慢性肺源性心脏病合并呼吸衰竭临床研究  

Clinical Study on Shenmai Injection Combined with Trimetazidine for Elderly Patients with Chronic Pulmonary Heart Disease Complicated with Respiratory Failure

作　　者：王志颖[1] 陈曦[2] 徐永伟 项伟忠[1] WANG Zhiying;CHEN Xi;XU Yongwei;XIANG Weizhong

机构地区：[1]丽水市中医院心内科,浙江丽水323000 [2]丽水市中医院呼吸科,浙江丽水323000

出　　处：《新中医》2022年第18期40-44,共5页New Chinese Medicine

摘　　要：目的:观察参麦注射液联合曲美他嗪治疗老年慢性肺源性心脏病合并呼吸衰竭的临床疗效。方法:选择慢性肺源性心脏病合并呼吸衰竭的老年患者78例,按照随机数字表法分为对照组与观察组各39例。对照组在常规治疗的基础上加用曲美他嗪治疗,观察组在对照组的基础上联合参麦注射液治疗。2组均连续治疗14 d,观察比较2组临床疗效、肺功能指标[第1秒用力呼气容积(FEV_(1))占预计值百分比(FEV_(1)%)、FEV_(1)与用力肺活量(FVC)的比值(FEV_(1)/FVC)、呼吸流量峰值(PEF)]、动脉血气指标[氧分压(PaO_(2))、二氧化碳分压(PaCO_(2))、酸碱度(pH)]、血清N-末端脑钠肽前体(NT-proBNP)、D-二聚体(D-D)、内皮素-1(ET-1)、心率、呼吸频率、不良反应。结果:总有效率观察组为100%,对照组为89.74%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组FEV_(1)%、FEV_(1)/FVC、PEF水平比较,差异均无统计学意义(P>0.05);治疗后,2组的FEV_(1)%、FEV_(1)/FVC、PEF水平均较治疗前升高(P<0.05),且观察组FEV_(1)%、FEV_(1)/FVC、PEF水平均高于对照组(P<0.05)。治疗前,2组PaO_(2)、PaCO_(2)、p H水平比较,差异均无统计学意义(P>0.05)。治疗后,2组PaO_(2)、pH水平均较治疗前升高(P<0.05),PaCO_(2)水平均较治疗前降低(P<0.05);且观察组PaO_(2)、pH水平高于对照组(P<0.05),PaCO_(2)水平低于对照组(P<0.05)。治疗前,2组血清NT-proBNP、D-D、ET-1水平比较,差异均无统计学意义(P>0.05);治疗后,2组NT-proBNP、D-D、ET-1水平均较治疗前降低(P<0.05),且观察组NT-proBNP、D-D、ET-1水平均低于对照组(P<0.05)。治疗前,2组心率、呼吸频率比较,差异均无统计学意义(P>0.05);治疗后,2组心率、呼吸频率均较治疗前降低(P<0.05),且观察组心率、呼吸频率均低于对照组(P<0.05)。观察组不良反应发生率为12.82%,对照组为7.69%,2组比较,差异无统计学意义(P>0.05)。结论:在常规治疗的基础上,采用参麦注射液联�Objective:To observe the clinical effect of the therapy of Shenmai injection combined with trimetazidine on elderly patients with chronic pulmonary heart disease complicated with respiratory failure.Methods:A total of 78 elderly patients with chronic pulmonary heart disease complicated with respiratory failure were selected and divided into the control group and the observation group according to the random number table method, with 39 cases in each group. The control group was additionally treated with trimetazidine based on the routine treatment, and the observation group was additionally treated with Shenmai injection based on the treatment of the control group. After 14 days of continuous treatment,the clinical effects, the lung function indexes, including the percentage of forced expiratory volume in one second(FEV_(1)) to the predicted value(FEV_(1)%), ratios of FEV_(1)and forced vital capacity(FVC)(FEV_(1)/FVC) and peak expiratory flow(PEF),arterial blood gas indexes,including partial pressure of oxygen(PaO_(2)),partial pressure of carbon dioxide(PaCO_(2)) and potentail of hydrogen(pH),serum N-terminal pro-brain natriuretic peptide(NT-proBNP),D-dimer(D-D),endothelin-1(ET-1),heart rates,respiratory rates and adverse reactions were observed and compared between the two groups. Results: The total effective rate was100% in the observation group and 89. 74% in the control group,the difference being significant(P<0.05).Before treatment,there was no significant difference being found in the comparisons of levels of FEV_(1)%,FEV_(1)/FVC and PEF between the two groups(P>0.05);after treatment,the levels of FEV_(1)%,FEV_(1)/FVC and PEF in the two groups were increased when compared with those before treatment(P<0.05), and the above three levels in the observation group were higher than those in the control group(P<0.05). Before treatment,the levels of PaO_(2),PaCO_(2)and p H were compared between the two groups,there being no significant differences(P<0.05). After treatment, the levels of PaO_(2)and pH in the two gro

关 键 词：肺源性心脏病 呼吸衰竭 参麦注射液 曲美他嗪 肺功能 N-末端脑钠肽前体 老年人 

分 类 号：R541.5[医药卫生—心血管疾病]